Business before Questions

Paterson Inquiry

Resolved,
That an humble Address be presented to Her Majesty, That she will be graciously pleased to give directions that there be laid before this House a Return of a Paper, entitled Report of the Independent Inquiry into the Issues raised by Paterson, dated 4 February 2020.—[Rebecca Harris.]

Oral
Answers to
Questions

Foreign and Commonwealth Office

The Secretary of State was asked—

NATO Allies

Gagan Mohindra: What diplomatic steps he is taking to strengthen relations with NATO allies.

Craig Williams: What diplomatic steps he is taking to strengthen relations with NATO allies.

Aaron Bell: What diplomatic steps he is taking to strengthen relations with NATO allies.

Dominic Raab: NATO protects nearly 1 billion people across 30 countries. It is the most successful alliance in history, and we are proud to be a leading member.

Gagan Mohindra: Does my right hon. Friend agree that NATO is the cornerstone of UK and Euro-Atlantic security? Will he support all efforts to increase burden sharing across the alliance?

Dominic Raab: My hon. Friend is absolutely right. Non-US defence investment has increased by £130 billion between 2016 and 2020. It is expected to rise further, by £400 billion, by 2024, and that is progress, but allies need to increase their defence spending in the way that he described. Of course, the UK is one of nine NATO allies meeting its 2% commitment, including a 20% increase in investment in new capabilities.

Craig Williams: Does my right hon. Friend agree that NATO is the cornerstone not only of UK security, but of Euro-Atlantic security? Will he prioritise it—I ask on behalf of Montgomeryshire constituents who have been asking me—to strengthen that alliance, to deal with the malign Russian threat?

Dominic Raab: My hon. Friend is absolutely right. We need to use NATO, and it will require reform to adapt to meet new threats. The way to do that is to strengthen and reinforce NATO, so that it can deal with state actors, including Russia, cyber, and all the modern threats. We are absolutely committed to doing that,  and bringing our European and north American allies together.

Aaron Bell: With the American primary season upon us, political tensions both within and between our NATO allies seem to be higher than ever. Does my right hon. Friend agree that that means we have a greater responsibility than ever, here in the UK, to promote diplomacy between our allies, and to speak judiciously when commenting on their internal politics?

Dominic Raab: My hon. Friend is right. He knows, from the last NATO leaders’ meeting, which the Prime Minister hosted and chaired, that we take that very seriously. We contribute to every NATO mission. We are the top defence spender in Europe, the second-largest in NATO as a whole, and the leading contributor to the NATO readiness initiative.

Lindsay Hoyle: Philip Dunne—not here.

Lloyd Russell-Moyle: During the recent NATO summit, there was a concerted effort by President Erdoğan of Turkey to block progress unless fellow NATO members agreed to label our Kurdish heroes in northern Syria as terrorists. After my last visit to Syria, the Secretary of State dismissed me and my concerns to try and reach out on that point. So maybe, if he refused to take advice from me and other members of the Opposition—and his two colleagues who came with me on that trip—he might take a lead from the Belgian court case that said that the Kurds were not a terrorist force; or the French, who objected publicly at the NATO council, as did Poland, the Baltic states, and even Donald Trump. I ask the Foreign Secretary: why did our own Prime Minister say nothing to defend the British interest and our Kurdish allies?

Dominic Raab: The hon. Gentleman is simply wrong. We have raised our concerns in relation to Turkey’s incursion into Syria, which obviously has affected some of our Kurdish partners in the region. We had a very successful NATO summit, precisely because the Prime Minister and the UK Government are focused on making NATO work, bringing all our allies together and making sure that our foes cannot exploit weaknesses or divisions between us.

Wayne David: Turkey’s relationship with its NATO allies is becoming ever more strained. Turkey’s incursion into northern Syria, which we have just heard about, and an increasingly close relationship with Russia are two clear examples of how tension is   being created within the alliance by Turkey. As we are a leading member of NATO, how do the Government think NATO should respond to the situation?

Dominic Raab: As with all strong partnerships within NATO, if we have issues we raise them candidly and clearly, and the relationship has the depth and the maturity to enable us to do so. We have expressed our disappointment, for example, that Turkey chose to acquire Russian S-400 air defence systems. None the less, Turkey remains a valued NATO ally, on the frontline of some of our most difficult security challenges, and I raised with the Turkish Foreign Minister on 5 January the positives and our concerns.

Gregory Campbell: The Minister rightly speaks of the success of NATO as an international peacekeeping force. Does he agree that part of the problem is that it does not get the international recognition for being that successful alliance? What more can we do to ensure that that is the case?

Dominic Raab: The hon. Gentleman is right: a lot of the solid, steady work that NATO is doing, and the work in bringing our allies together, goes unnoticed, as is often the case in security. The most important thing the UK can do is continue to lead by example. We contribute to every NATO mission. This includes: leading the enhanced forward presence battle group in Estonia; contributing to the US battle group in Poland; and working with our NATO allies on operations in Afghanistan and Iraq, and we will continue to do all those things.

Lilian Greenwood: What recent discussions he has had with his European counterparts on future co-operation after the UK leaves the EU.

Dominic Raab: Following the protocol at international meetings to make sure that the UK is asserting its voice confidently, and in tandem with but independently of our allies, is absolutely the right thing. That is what the referendum required and that is what we are doing.

Ukraine

John Whittingdale: What steps he is taking to support political development in Ukraine; and if he will make a statement.

Christopher Pincher: The United Kingdom is a strong supporter of Ukraine’s sovereignty and territorial integrity, and President Zelensky’s commitment to reform and fighting corruption. We have provided financial support to the tune of £38 million this year, across multiple areas, and we lead robust sanctions on Russia for its attacks on Ukraine’s sovereignty. We look forward to welcoming President Zelensky to the UK as soon as a date can be found.

John Whittingdale: Will my right hon. Friend welcome President Zelensky’s decision to extend the visa-free regime for UK citizens for another year? Does my right hon. Friend share his ambition for Britain and Ukraine to conclude a new framework agreement as soon as possible, including possible liberalisation of the visa regime for Ukrainian citizens?

Christopher Pincher: My right hon. Friend is a doughty champion of Ukraine’s determination to look westward and be a modern European country. We will certainly welcome, as soon as we can, the ratification of such an arrangement, and I congratulate the President on his announcement on visa-free access for UK nationals. That will certainly help trade with the UK, which we want to ensure is successful, but we also need to protect our own borders. The Home Secretary is responsible for border control, but we keep our border policy under constant review, and visas to and from Ukraine is something I discuss with her regularly.

Jim Shannon: On political development and the importance of having human rights protected, including in Ukraine, I am aware of a number of examples where Christians have been persecuted, injured and politically challenged for their beliefs. What has been done in discussions with Ukraine to ensure that human rights are protected and people have the right to express themselves?

Christopher Pincher: I am obliged to the hon. Gentleman for his question. We of course discuss these matters with Ukraine. I am particularly concerned about the repression of fundamental human rights—the right to speak the Crimean language—in Crimea by the annexing forces, and I raised that issue when I went to Kiev last year. We will always place these issues, be they in Ukraine or elsewhere, high on the agenda.

Climate Change

Henry Smith: What progress the Government have made on tackling climate change through international co-operation.

Siobhan Baillie: What progress the Government have made on tackling climate change through international co-operation.

Paul Howell: What progress the Government have made on tackling climate change through international co-operation.

Heather Wheeler: Climate change is not a distant threat. We must act together to accelerate action. The UK has already doubled its international climate finance funding from £5.6 billion to £11.6 billion, and is investing £220 million in a new international biodiversity fund.

Henry Smith: I am grateful to my hon. Friend for that answer. Does she agree that increasing the UK’s climate diplomacy capabilities is important for a successful COP26 conference in Glasgow later this year, so that we can be more successful than last year’s conference  in Madrid?

Heather Wheeler: The UK was disappointed at the lack of progress made at COP25 in Madrid. The UK and Italian diplomatic efforts will be squarely focused on achieving a successful COP26. COP is about more than negotiations; it is about real change happening across countries, civil society and the private sector. These broader elements will be a primary focus of COP26.

Siobhan Baillie: At the weekend, I had the pleasure of attending a Stroud Greenpeace exhibition about climate change and protecting our oceans. Will the Foreign and Commonwealth Office continue to advocate for international agreement on climate change at the United Nations? Will the Minister tell us more about the Government’s commitment to protecting our oceans and the work on the UN global treaty negotiations?

Heather Wheeler: I thank my hon. Friend for that question. This is the first time I have answered a question from her, so I welcome her to her place.
I welcome my hon. Friend’s view on international oceans. We are looking for a maximum ambition on oceans to protect them for future generations, and I am working hard with Lord Goldsmith on that ambitious project.

Paul Howell: Both the councils in the Sedgefield constituency—Darlington and Durham—have declared climate change emergencies, but given the relatively low impact of the UK on climate change compared with places such as China, how do we convince our constituents to engage? Does the Minister agree that it is imperative that we not only challenge other countries to make progress but share the efforts that our international colleagues are making, in order to motivate and share good practice?

Heather Wheeler: I hope my hon. Friend, whom I welcome to his place, will excuse my having my back to him as I speak to the Chair.
My hon. Friend is absolutely right that climate change is one of the most urgent and pressing challenges we face today, so no country can solve the problem alone. COP26 in November will bring together more than 300,000 delegates from around the world to tackle climate change. It is vital that all countries come together and come forward with increased pledges and nationally determined contributions in the coming months. The UK has committed to increasing our international climate ambition and NDCs before COP26.

Emily Thornberry: We meet today on the 75th anniversary of the Yalta conference, at which Churchill, Roosevelt and Stalin carved up post-war Europe, and in doing so unwittingly created the conditions for half a century of cold war between east and west. Their mistakes were eventually fixed, but when we have conferences that affect the climate emergency today, we have to realise that it is too late to fix any more mistakes as we rapidly approach the point of no return on global warming, so let me ask a specific question. When the Prime Minister hosted the UK-Africa trade summit just a fortnight ago, he told its delegates that
“we all suffer when carbon emissions rise and the planet warms.”
Will the Minister tell us what percentage of the energy deals that were struck at that summit were based on the mining of fossil fuels?

Heather Wheeler: I thank the right hon. Lady for that question. She always puts her questions so perfectly; her diction is superb for the House. Everybody was clear about what she said.
We are weaning all the world off coal. The Powering Past Coal Alliance, which is clearing away from coal, is very important. We are leading on that and my hon. Friend the Minister for Africa, who led at the Africa conference, has managed to secure an amazing deal on that. We are looking towards the bright future that that Prime Minister has been talking about today.

Emily Thornberry: The hon. Lady focuses on coal and boasts about the announcement on coal, but according to the Environmental Audit Committee, UK Export Finance has not supported a single coal project since 2002. I do not know whether she is uncertain about  the answer or just too embarrassed to answer, but the reality is that more than 90% of the £2 billion of investment in energy deals that was agreed at the UK-Africa trade summit was committed to new drilling for oil and gas—more fossil fuels. None of that was mentioned in the Government press release, which focused instead on the paltry figures for investment in solar power. Does the Minister accept that she is part of a Government who talk the talk on climate change but never walk the walk? They make symbolic moves on the domestic front but will never take any global lead. Worst of all, they refuse to stand up to the climate denier—

Lindsay Hoyle: Order. We have to get to the question; we cannot keep reading out a statement. A quick question, please.

Emily Thornberry: Worst of all, the Government refuse to stand up to the climate denier-in-chief, Donald Trump. Does the Minister not realise that in the face of this climate emergency we no longer have time for cowardice?

Heather Wheeler: Shall I be succinct, Mr Speaker? We recognise that countries will continue to need to use a mixture of energy sources, including renewable energy and lower-carbon fossil fuels such as natural gas, as part of the transition towards a low-carbon, sustainable economy. I am afraid the right hon. Lady is making too much hot air today.

Derek Twigg: What evidence does the Minister have that the Government’s diplomacy is having an impact on the biggest polluters, such as China and United States, in that those countries are prepared to do something more than they are doing now?

Heather Wheeler: I thank the hon. Gentleman for his question. We are working very closely with countries around the world. I have been to five of the Association of Southeast Asian Nations so far, and, at every opportunity I have asked them to have more ambitious targets for reducing their carbon emissions, and that is exactly what will happen when our Secretary of State meets representatives in China very soon.

Wuhan: UK Nationals

Andrew Rosindell: What recent discussions he has had with his Chinese counterpart on the situation in Wuhan.

Dominic Raab: I spoke to Chinese Foreign Minister Wang Yi on 28 January about the evacuation of UK nationals from Wuhan and also about UK medical supplies to help the Chinese authorities tackle the coronavirus.

Andrew Rosindell: I thank the Foreign Secretary for his reply, but does he agree that the safety and security of British nationals must be our primary concern, and will he therefore press the Chinese authorities to co-operate in granting any assistance necessary to ensure that our nationals are looked after while they remain in China?

Dominic Raab: My hon. Friend is absolutely right, and those are precisely the issues that I raised with the Chinese Foreign Minister. In fairness, we have seen 83 British nationals repatriated on Friday, and another seven British nationals and four dependants evacuated on a French flight that returned to the UK on Sunday. I can also tell him that we have been allocated 14 places on an Air New Zealand flight today for UK nationals and their dependants.

Afzal Khan: The evacuation of British nationals and their families from Wuhan has been nothing short of a shambles, given the delays, the lack of information and the terrible cases of family separation that have occurred. Why on earth does the Foreign Office not have protocols and plans in place to manage these crises when they occur?

Dominic Raab: The hon. Gentleman is quite wrong on everything that he has just said. I visited the crisis centre yesterday. We have an excellent cross-Whitehall team, including the Ministry of Defence and the Department of Health and Social Care working with our consular officers. There are challenges dealing with the Chinese authorities in relation to the permissions to get the charter flight in and to get people to the muster points. We hired four coaches for the first flight that arrived on Friday, and we delayed the flight for three hours on the tarmac to ensure that all the people who needed to get on could get on, and of course we will continue working with our international partners and the Chinese to get those who need to come home out of the country.

Prosperity in Africa

Harriett Baldwin: What diplomatic steps his Department is taking to help promote prosperity in Africa.

Mark Fletcher: What diplomatic steps his Department is taking to help promote prosperity in Africa.

Andrew Stephenson: Increased trade and investment in Africa will improve African Government revenues, and support job creation and economic growth, which is beneficial for African  states and the United Kingdom. On 20 January, the Government hosted the UK-Africa investment summit, where £6.5 billion-worth of commercial deals and £1.5 billion-worth of Government funding initiatives were announced. Commitments announced at the AIS will help to drive prosperity across the continent.

Harriett Baldwin: I congratulate my hon. Friend and everyone involved in the very successful Africa investment summit. Will there be another one and, if so, what would the African countries that were not invited to this one need to do to get an invite to the next one?

Andrew Stephenson: I start by paying tribute to my predecessor for the work that she did in the early preparations for the summit. The summit achieved its objectives of laying the foundations for a new, stronger relationship between the United Kingdom and Africa, based on mutually beneficial trade and investment. Following our departure from the European Union, the Government will build further on those foundations in a range of ways, and we are currently looking at the feedback from the summit.

Mark Fletcher: I echo the comments of my hon. Friend the Member for West Worcestershire (Harriett Baldwin) on the Africa investment summit. Too often, Britain’s interests when it comes to Africa are piecemeal and we are not good enough when it comes to sustained engagement, so what plans does the Minister have to engage with the African Union on a regular basis?

Andrew Stephenson: Excellent. I very much welcome that question. The African Union is justifiably seen internationally as a strong and influential partner, able to bring African countries together. During the Africa investment summit, chairperson Faki met the Prime Minister and my right hon. Friend the Foreign Secretary. To support the development of the African continental free trade area, the Secretary of State for International Trade announced a £200 million southern African regional trading connectivity programme and a £20 million trade connect programme at the summit, which will further and deepen our partnership with the African Union.

Fabian Hamilton: May I ask the Minister how much time during the UK- Africa investment summit last month was dedicated to  discussing the elimination of corruption and the protection of human rights, as two of the key preconditions of  any new trade deals, especially given the presence of  a notorious human rights abuser such as Egypt’s President Sisi?

Andrew Stephenson: The subject of human rights was raised by the Foreign Secretary in every single one of his bilateral meetings. Corruption is a barrier to business and growth, which is why the Foreign and Commonwealth Office, through the prosperity fund, is investing in extensive anti-corruption projects in Africa, including legal reforms,   policy reforms and transparency reforms, and operational work to recover the billions that have been stolen from the African people over the years.

Chris Elmore: As trade negotiations progress with Africa, there will be conflicting pressures with our trade negotiations with the US and South American states. What reassurance can the Minister give me that he will put pressure on the Department for International Trade to ensure that Africa is prioritised when it comes to trade deals, and does not lose out as a result of US or South American deals?

Andrew Stephenson: The very fact that we have hosted an Africa investment summit indicates the Government’s strategic priority towards Africa. We are opening five new missions in Africa, and are increasing the number of our staff—including Department for International Trade staff—across the continent by 400. Africa is a key trading partner, and UK-Africa trade increased by 7.5% last year to £36 billion.

UK Nationals: Consular Support

Anthony Browne: What steps he is taking to strengthen consular support for UK nationals overseas.

Andrew Stephenson: Our consular staff help more than 20,000 British people abroad every year. The support is tailored to the individual circumstances of each case, and prioritises those who are most in need. We constantly strive to improve our support, and use customer feedback to improve our services and staff skills.

Anthony Browne: I very much welcome the assurances that this Government have given to the 3 million EU nationals who will continue living in the UK after the transition period, but we have heard far less about the rights of the 1 million UK citizens living in the EU post Brexit. What work is the Department doing to help preserve those UK citizens’ futures?

Andrew Stephenson: Protecting citizens’ rights in the EU is absolutely a priority for the Government. The withdrawal agreement provides certainty for UK nationals living in the EU about their rights going forward. The Foreign and Commonwealth Office is proactively engaging with EU member states to ensure full and timely implementation of the withdrawal agreement.

Hannah Bardell: Do the Minister, the Secretary of State and the Government believe that UK citizens deserve the right to consular services and support enshrined in law?

Andrew Stephenson: There is currently no legal right to consular assistance. Domestic law would not improve the outcomes for our most complex cases. Even if there was a right to assistance, the Government’s ability to provide it would remain dependent on other states respecting that.

Hannah Bardell: I thank the Minister for his answer, but with respect I disagree. In December last year, the all-party parliamentary group on deaths abroad and consular services and assistance—which I founded  and chair, and of which many of the Minister’s  colleagues have been members—published its report, with 92 recommendations. We took evidence from  more than 60 families from across the UK whose loved ones died abroad in suspicious circumstances or are being incarcerated against their will, and they said that they feel they are being let down by the Foreign and Commonwealth Office. With Brexit set to make international co-operation harder and this Government’s cuts resulting in the reduction of more than 1,000 diplomatic staff, UK citizens deserve better. Will the Secretary of State or the Minister meet me to discuss enshrining  into law—

Lindsay Hoyle: Order. We must have short questions. I call the Minister to respond.

Andrew Stephenson: I thank the hon. Lady for her question. I have already agreed to meet her, as did my predecessor, but neither offer has been taken up. On  23 January, the consular murder and manslaughter team held a workshop bringing together key stakeholders, including Murdered Abroad, the Help for Victims homicide service, the Ministry of Justice, the Metropolitan police and the Chief Coroner’s Office to focus on always improving our support for bereaved families. I participated in that meeting. We will always strive to improve the service that we provide to those who have loved ones murdered abroad.

Jeremy Hunt: One of the consular cases most on the minds of people in this House is that of Nazanin Zaghari-Ratcliffe. Does the Minister agree that western countries need to work together to call out the vile practice of hostage-taking by countries such as Iran? Article 4 of the NATO treaty says if that one country is invaded, all have to treat it as if they have been invaded. Should we not do the same when our innocent citizens are taken hostage?

Andrew Stephenson: I applaud my right hon. Friend for his question and the work that he did on this case when he was Foreign Secretary. The Prime Minister met Richard Ratcliffe on 23 January. We continue to make strong representations to send a clear signal in this case that Iran’s behaviour is totally wrong and unacceptable.

Middle East Peace Plan

Philip Hollobone: What steps he plans to take to encourage (a) his Israeli counterpart, (b) the Palestinian Authority and (c) other middle east states to discuss the potential merits of the US Administration’s Peace to Prosperity plan.

Wes Streeting: What representations he has made to his counterpart in the US Administration on the proposed peace deal for the middle east.

Chi Onwurah: What representations he has made to his counterpart in the US Administration on the proposed peace deal for the middle east.

Dominic Raab: We welcome the US proposals for peace talks between the Israelis and the Palestinians based on recognition of the two-state solution. We support this initiative to get both sides around the negotiating table.

Philip Hollobone: Does the Foreign Secretary agree that the United States’ “Peace to Prosperity” plan is a set of serious and constructive proposals that deserves more than instant rejection, and that whatever the pros and cons of the plan, if we are to secure a lasting peace, the only way to do so is through direct talks between the Palestinians and the Israelis?

Dominic Raab: I thank my hon. Friend. This is a first step on the road back to negotiations. The absence of dialogue creates a vacuum that only fuels instability and leads to the drifting of the two sides further and further apart, so whatever the different views, we want both sides to get around the negotiating table to work to improve the plan and to get peace in the middle east.

Wes Streeting: A peace plan without Palestinian participation is not a peace plan—it is an annexation plan. Can the Secretary of State assure us that the Government will not accept either this plan or any unilateral annexation plan, and perhaps take the step now to recognise an independent Palestinian state before there is no state left to recognise?

Dominic Raab: I certainly agree with the hon. Gentleman that any annexation unilaterally would be contrary to international law, damaging to peace efforts, and cannot go unchallenged, but the answer is to get both sides around the negotiating table. That is why not only the UK but the French, the Italians, EU High Representative Josep Borrell, Japan, India, South Korea, Saudi Arabia, Egypt and Oman have all called for the parties, based on this initiative, to come back to talks.

Chi Onwurah: I am sure that the Secretary of State considers himself a friend of the people of Israel, as I do, and of America, and, I hope, of Palestine. Does he agree that it is the duty of real friends to speak the truth at difficult times? The truth is that this is no peace plan: worse, by making the Palestinians spectators in their own land, annexing illegal settlements and destroying hopes, it paves the way for further conflict. Will he speak that truth to Israel and America?

Dominic Raab: The hon. Lady is absolutely right that we need to speak candidly on all sides of this debate. I have spoken to the Americans. I also spoke to President Abbas on 27 January. The reality is that whatever concerns any side has about this set of proposals, they will get resolved and improved only with both sides around the negotiating table. Rejectionism—the current vacuum—is only making matters worse. We would like to see peaceful dialogue and a negotiated solution, and that must be based on the two-state solution and the principles of international law.

Khalid Mahmood: The 22-member Arab League and the 57-member Organisation of Islamic Co-operation have both rejected the so-called Trump peace plan, because they recognise that it has no benefit for the Palestinian people, so why do the British Government continue to support it?

Dominic Raab: We support it along with—the hon. Gentleman failed to mention this—the Saudis, the Egyptians, the Omanis and Qatar. They have all given statements saying that it is a first step on the road to negotiations that can resolve the conflict. [Interruption.] They put out two statements. I heard the right hon. Member for Islington South and Finsbury (Emily Thornberry) chuntering from a sedentary position. The reality is that rejectionism—the vacuum that currently exists—will only make matters worse. We want to see a negotiated two-state solution. That will happen only if both parties come to the negotiating table.

Libya: Peace Process

Giles Watling: What steps he is taking to help support the peace process in Libya.

Andrew Murrison: The Berlin conference attended by the Prime Minister on 19 January showed wide international support for a ceasefire, resumption of UN-led political talks and an end to external interference. International actors agreed to freeze military activity on the ground, not to send reinforcements and to respect the UN arms embargo. All parties must honour their Berlin commitments and demonstrate their support for the UN-led political process.

Giles Watling: I thank the Minister for his answer. Libya seems to have drifted out of the headlines somewhat, and this war has been going on for 11 years. The Russo-Turkish Libyan initiative has now failed, and we must not take our eyes off the ball. Are we sure that we are not being short-sighted and piecemeal, when what Libya really needs is long-term international efforts diplomatically and on the ground?

Andrew Murrison: My hon. Friend is right to say that this is a very busy region indeed. However, I disagree that the international community is taking its eye off the ball—witness the Berlin process and activities at the United Nations. I shall be going to Ankara tonight, and I will of course be talking about Libya, among other things, with my Turkish interlocuters tomorrow.

Lindsay Hoyle: I call Toby Perkins—not here.

Gambia: Arrests of Protestors

Anne McLaughlin: What representations he has made to his Gambian counterpart on reports of arrests of peaceful protestors by Gambian security forces. 
What the Gambia did in coming together to rid itself of the human rights abuses of former President Jammeh was nothing short of spectacular and gave a real opportunity to build a world-leading democracy, but last week, hundreds were beaten by security forces for  peacefully demonstrating. Four journalists were detained and charged with incitement, and two radio stations have been closed down. Using the Government’s global media freedom campaign, what can the Minister do to support the majority of Gambians, who are terrified that this is the start of a slippery slope backwards, when they clearly want to go forwards?

Andrew Stephenson: I thank the hon. Lady for her question. We are concerned that the political protests on 26 January turned violent. We are monitoring the investigations into that incident closely through our high commission. The UK is clear that the right to peaceful protest and media freedom must be upheld without recourse to violence and intimidation.

Leaving the EU: Human Rights

Tim Loughton: What plans he has to bring forward legislative proposals for a UK autonomous global human rights sanctions regime after the UK leaves the EU.

Dominic Raab: Now that we have left the EU and regained control of our sanctions rules, we will be bringing into force our own global human rights Magnitsky-style sanctions regime, which will give us a powerful new tool to hold the world’s human rights abusers to account.

Tim Loughton: Does my right hon. Friend agree that any new Magnitsky legislation must be targeted at the worst human rights abusers, including those perpetrating terror against minorities in China, most notably the Uighurs and the Tibetans? To that end, will he support my Tibet (Reciprocal Access) Bill, mirroring legislation passed in the US which is throwing a spotlight on some of the worst human rights abuses against the Tibetans within China?

Dominic Raab: I thank my hon. Friend for his question and pay tribute to his tenacious efforts in this regard. When I was in Washington, on the hill, I had a number of conversations about US legislation and the approach it is taking. He is right to say that our regime should target the worst human rights abusers. He will see the individuals designated in due course, but I can reassure him that our approach will be universal in its scope.

Alison McGovern: The 6,500 children fleeing Idlib in Syria daily, where barrel bombs are being used on hospitals and schools, must wonder where on earth the protectors of their human rights are. Unfortunately, in this House we have all but forgotten them. What is the Foreign Secretary’s plan to ensure that those children know that their human rights are protected?

Dominic Raab: I share the hon. Lady’s concern about the situation in Syria. We encourage all the actors—whether it is the Russians, the Turks or, indeed, the Assad regime itself—to find a peaceful way through. We support the UN efforts to find a peaceful solution and, in particular,   the humanitarian relief, which will provide relief to the children and other vulnerable people suffering in that terrible conflict.

Iraq

Jessica Morden: What recent assessment he has made of the security situation in Iraq.

Andrew Murrison: The security situation in Iraq is deeply worrying. The threat from Daesh remains, and the recent attacks by Shi’a military groups on diplomatic premises are unacceptable, as is the use of disproportionate force against demonstrators. We are committed to supporting the Government of Iraq to face its profound security challenges. The Prime Minister reaffirmed that with his Iraqi counterpart on 5 January, and we stand ready to work with the new Prime Minister Mohammed Allawi.

Jessica Morden: Members of the Kurdish community in Newport have contacted me as they are very concerned that the recent vote in the Iraqi Parliament on expelling foreign forces will leave the Kurdish people, scarred by war over many years, even more vulnerable. What will Ministers do to act on their behalf?

Andrew Murrison: I thank the hon. Lady for her supplementary question. I spoke to the Prime Minister of the Kurdistan region of Iraq, Masrour Barzani, recently—last month—and we discussed this issue, among others. She is right to say that the security of the region is of vital importance, and we will do all we can to work with our friends to assure that, including helping to train the peshmerga.

Middle East

Caroline Ansell: What diplomatic steps he is taking to help de-escalate tensions in the middle east.

Jack Lopresti: What diplomatic steps he is taking to help de-escalate tensions in the middle east.

Andrew Murrison: As I said on 14 January, our strategic aims remain to de-escalate US-Iran tensions, constrain Iran’s nuclear development and hold Iran to account for destabilising activity in the middle east. We remain fully committed to the joint comprehensive plan of action. The Prime Minister, the Foreign Secretary, the Defence Secretary and I have all spoken to counterparts in the United States, Iran and across the region to underline the need for de-escalation on all sides.

Caroline Ansell: Any unified and prosperous Palestinian state living peacefully alongside Israel is unrealistic as long as the Hamas terror group continues to be committed to the destruction of Israel. Will my right hon. Friend join me in calling for renewed international pressure on Hamas to renounce violence and to disarm?

Andrew Murrison: My hon. Friend is of course absolutely right. The renunciation of violence and the return to the political process are of crucial importance in trying to get towards what I think we all want in this House, which is a peaceful and amicable settlement that respects the 1967 borders, with Jerusalem as a shared capital, and in particular a deal that gives refugees, of whom there are a huge number in the region, a proper future.

Jack Lopresti: Does my right hon. Friend agree that one of the ways we can help to secure a long-lasting peace between the Israelis and the Palestinians is by working with our allies to support initiatives that promote dialogue and co-existence, such as the international fund for Israeli-Palestinian peace, as well as ensuring that UK taxpayers’ money is not misdirected or misused but goes to the people who actually need it?

Andrew Murrison: My hon. Friend is absolutely right. There are of course a large number of projects and initiatives, many of them funded by the United Kingdom, that are aimed at promoting peace. He will be aware that we are one of the major contributors to the humanitarian situation—we hope, of course, pro tem—before we get a definitive political process that enables a viable Palestinian state to live alongside the state of Israel.

Kevin Brennan: In relation to de-escalating tensions, may I thank the Minister for having met my constituent Mr Robert Cummings, the grandfather of Luke Symons, who is being held by Houthis in Sana’a? May I convey, through him, a request for an opportunity to meet the Foreign Secretary himself to discuss the case further?

Andrew Murrison: I am grateful to the hon. Gentleman. We have discussed the case of Luke Symons at some length, and of course my door always remains open. We continue to do what we can in a very difficult and challenging situation with our interlocutors and partners to secure the outcome that I know the hon. Gentleman wants for Mr Cummings.

Australian Bushfires

Peter Gibson: What support the Government are providing to Australia to help tackle the bushfires in that country.

Heather Wheeler: The UK deployed a team of experts on 8 January to assess what support Australia needs, and we are working with Australia to establish where we can work together on this issue.

Peter Gibson: I welcome the Government’s pledge to create 500 new hectares of vibrant ecosystems here, but Australia’s ecosystems are facing unprecedented threats following these bushfires. What steps is the Department taking to assist the Australian Government in the recovery of these precious habitats?

Heather Wheeler: I thank my hon. Friend for his question. One of the pieces of work we are doing with Australia, I hope, is on biodiversity and specifically on seeds. We are  hoping to work with Kew so that the re-energising of that biodiversity area, which has been so badly affected, will come to fruition, if I can use that word. It is excellent that our experts will be working completely hand in hand with the Australian authorities.

Jeff Smith: What discussions have the Government had with the Australian Government about the link between the bushfires and climate change to make sure that the Australian Government get serious about tackling carbon emissions in their country?

Heather Wheeler: I thank my hon. Friend for his question. Australia is a signatory to the Paris agreement, and a number of Australian states have already committed to net zero by 2050. Ahead of COP26 we look forward to working with Australia to increase its climate ambition, in line with principles that it has already agreed to.

Topical Questions

Alison Thewliss: If he will make a statement on his departmental responsibilities.

Dominic Raab: Last week we left the European Union to become an independent country, delivering on the promise made by politicians to the British people. Later today I will be departing for Australia, Japan, Malaysia and Singapore, to deliver on this Government’s vision of a truly global Britain.

Alison Thewliss: Yesterday the World Health Organisation evacuated 30 patients from Yemen who needed urgent medical treatment, including several children, but those are very much the lucky exceptions. What is the Foreign Secretary doing, together with his international counterparts, to negotiate peace in Yemen, so that all its people can receive medical assistance when they need it?

Dominic Raab: The hon. Lady raises a conflict that I, and the whole Government, are very concerned about. We work with all our international partners, and in the past week I met the Saudi Foreign Minister to consider how we can pursue dialogue and get a peaceful resolution to that conflict, not only for the parties and the region, but also for the vulnerable people affected.

Dean Russell: I was at Vicarage Road on Saturday, when both goals for Watford were scored by foreign players. Will the Secretary of State assure me that the premier league will still be able to attract talent and international players from around the world?

Heather Wheeler: What an excellent question, particularly bearing in mind how important soft power is to our standing in the world. We are proud to host the best league in the world, showcasing the greatest talent in the world, and this year we will welcome our European friends to Glasgow and London for Euro 2020—yes, my hon. Friend can be assured about that.

Marsha de Cordova: As the Foreign Secretary should be aware, members of the Public and Commercial Services Union who are employed by Interserve at the Foreign and Commonwealth Office have begun a month of strike action. The dispute is over a lack of trade union recognition for collective bargaining purposes, sick pay, and unfair contractual changes. I am pleased that some of those workers are here today watching proceedings, and I stand in solidarity with them in their fight for dignity, respect, and fair treatment at work. Will the Foreign Secretary urgently review the situation, and work with all parties to bring the dispute to an end and achieve a fair and dignified resolution?

Heather Wheeler: That is exactly what we would like to happen. The Foreign Secretary has already underwritten financial arrangements between Interserve and the employees, and we would like everybody to go back to ACAS and get this settled.

Caroline Ansell: Does the Minister share my view that unless and until peaceful co-existence is taught, championed and modelled in Palestinian schools, any peace deal with Israel will be short-lived?

Andrew Murrison: My hon. Friend is right, and she will be aware of the support that we give for health and education in the occupied Palestinian territories, pending the definitive political solution that we would like to see in the not-too-distant future, which remains a huge priority. She will also be aware of concerns about things such as teaching materials in schools, and of the active role that we have taken to ensure that no inappropriate material is used. I spoke recently to the Palestinian Education Minister. I know that this issue is at the top of his agenda, and in advance of the academic year in September, changes will be made.

Stephen Kinnock: For those who believe in the international rules-based order, the Trump annexation plan is an utter disaster that ushers in the law of the jungle. If the British Government support this plan, surely they will also be giving a green light to Russia and China for their various annexation activities. If it is okay for Israel to do this, what will the Foreign Secretary say to Russia and China?

Dominic Raab: I think the hon. Gentleman has misunderstood the UK position. There is a proposal for peace talks, which would require a two-state solution, based on both sides agreeing. We have made it clear that we would disagree with and challenge any unilateral annexation on the basis of settlements.

Tim Loughton: Soft power will be increasingly important in the post-Brexit world. Among the many international treasures the UK can marshal is the BBC World Service, with an audience of over 320 million. After the BBC recently reneged on the funding agreement for free TV licences for over-75s, will the Minister ensure that the BBC does not try to compensate by raiding the BBC World Service budget and endangering this vital resource?

Heather Wheeler: I thank my hon. Friend for that very interesting question. He is quite right: the BBC World Service does reach 319 million people weekly. It is incredibly important that that carries on. We have the 2020 agreement between the BBC and Her Majesty’s Government to invest huge amounts of money and we want that to continue.

Debbie Abrahams: The National Federation of Indian Women estimates that 13,000 teenage boys from Jammu-Kashmir have been detained following the revocation of article 370 on 5 August. Will the Secretary of State support a fact-finding delegation from the all-party group on Kashmir to the region, given that so many of the UK’s Kashmiri diaspora still have family members there?

Heather Wheeler: The Foreign Secretary raised this issue with the Foreign Minister for India. Perhaps I could write to the hon. Lady afterwards.

Joy Morrissey: Will the Minister provide an update on why the Chinese Government are not giving permission for their citizens to leave the country with their British partners?

Dominic Raab: I appreciate my hon. Friend raising this very important issue. There are huge challenges in dealing with the coronavirus outbreak. We are working collaboratively with the Chinese. There is clearly a tension between the desire from our point of view to ensure that UK nationals and their dependants, whatever their nationality, can return to the UK, and the legitimate desire of the Chinese to prevent the spread of the virus. I have spoken to the Chinese Foreign Minister and received reassurances that no UK-national-related families who want to return to the UK will find themselves divided on the basis of dual or split nationality among their families.

Chris Matheson: Does the Minister agree, with regard to the Trump so-called peace deal, that since no Palestinians were involved in negotiating it, it is not a negotiation or a deal but an imposition and that therefore an imposition is no basis for a lasting peace?

Dominic Raab: The hon. Gentleman is putting the cart before the horse. He is right that both sides will need to agree a two-state solution based on coherent, credible states on both sides and with the security considerations without any lateral annexation—[Interruption.] The right hon. Member for Islington South and Finsbury (Emily Thornberry) is again speaking from a sedentary position. There will need to be the resolution of all the key final status issues, including Jerusalem and refugees. But we have to get out of this vacuum and the only way we will do that is if both sides come to the negotiating table.

Dehenna Davison: The Prime Minister’s speech yesterday was welcomed by many businesses in Bishop Auckland for his words about championing free trade globally. On freedom, a number of my constituents have been in touch to ask specifically what we can do to help to promote freedom in Venezuela.

Dominic Raab: My hon. Friend is right to tirelessly champion freedom across the world. I met interim President Guaidó. We continue to want a peaceful resolution of the situation in Venezuela and a transition to free elections which are credible for the people of Venezuela.

Deidre Brock: This morning, the now-sacked President of COP26 said that the Prime Minister has shown,
“a huge lack of leadership and engagement”
and “doesn’t really understand” climate change, which has led to the UK being “miles off” globally from where we need to be. Now rumours are flying around suggesting that the Government are planning to shift COP26 from Glasgow to an English location. What on earth are the public supposed to make of this shambles?

Dominic Raab: The hon. Lady will not need to wait long, because today, with Sir Richard Attenborough, the Prime Minister is launching and setting out the detail of our approach to COP26, where we will lead in bringing the world together to tackle one of the global challenges of our age.

Steve Double: With regard to Hong Kong BNO—British National (Overseas)—passport holders, can the Secretary of State say whether the Government consider them to be British or Chinese nationals? If it is British, what more can we do to enable them to access consular support in the place they live?

Dominic Raab: The BNO passport holders have, by definition, a bespoke status. They have Chinese and British nationality, but they are not British citizens. They hold a BNO passport, which entitles them to consular support when travelling away from home. It also entitles them to six months entry clearance into the UK. That, as I think my hon. Friend will know, was agreed as part of the arrangements around the joint declaration in 1984. We support that. We want to see one country-two systems upheld, precisely because it is the best way of ensuring the freedoms and the autonomy of the people of Hong Kong.

Martin Docherty: My constituent, Jagtar Singh Johal, has been incarcerated in the Republic of India for 830 days. Will the Foreign Secretary consider meeting me and Jagtar’s family to assure them that while he is pursuing a free trade British agenda, he will not sacrifice our commitment to openness, transparency and due process in any future free trade agreement?

Andrew Stephenson: We take allegations of torture and mistreatment very seriously and we raise them with the Indian authorities. I know that the hon. Gentleman recently met Lord Ahmad on 23 October and 19 December. I am happy to arrange another meeting with Lord Ahmad or to have a meeting with him myself.

Thomas Tugendhat: My right hon. Friend the Foreign Secretary has touched on the COP26 preparations. Will he talk a bit about the strategy that the FCO will take on the Kunming biodiversity   conference and the UN ocean conference in Lisbon, because clearly, climate change diplomacy will be absolutely front and centre of his agenda?

Dominic Raab: My hon. Friend is absolutely right that in all those conferences, we want to lead with an ambitious approach to tackling climate change. The Prime Minister is setting out with Sir Richard Attenborough today the approach to COP26, and if my hon. Friend would like any more detail, I would be very happy to write to him.

Jeff Smith: With the rights of indigenous peoples in danger around the world—particularly from the Bolsonaro Government in Brazil—does the Minister agree that the rights of indigenous peoples should be embedded in the proposed international treaty on human rights and transnational corporations?

Christopher Pincher: I think the hon. Gentleman was present at a Westminster Hall debate last year when I made clear the work that the British Government are doing to help indigenous peoples in places such as Brazil. We have to make sure that we support such people. I think the point was made by the former Member for Bishop Auckland that tariffs are a good thing. Tariffs hurt the poorest and tariffs on food hurt the very poorest. We will make sure that we support indigenous peoples wherever they are, and particularly in Brazil.

Stephen Crabb: I note the Minister’s earlier remarks about the Iran nuclear deal, but does he accept that since it was signed in 2015, Iran has launched major cyber-attacks against the UK, including on this Parliament? It has used its warships to harass our fleets in the Gulf and it has supported a huge arms build-up in the middle east. Where is the evidence that Iran can be a trusted partner for peace?

Dominic Raab: My right hon. Friend is right to point out not only the systematic Iranian non-compliance on the nuclear front, but its wider destabilising activities in the region and its use of covert cyber-attacks against western interests. The reality is that we want to hold Iran to account every time it steps beyond the international pale, but we also want to leave the door ajar for it to take the confidence-building steps—when the regime in Tehran makes that decision, as only it can—to come  in from the international cold.

Jim Shannon: Can the Minister outline the discussions that he has had with our Commonwealth ally, India, about its industry and climate change and how we can help it to be sustainable, environmentally friendly and reduce emissions while carrying on with its industry?

Dominic Raab: My hon. Friend is right not just to ask that specific question, but to do so in that tone. As COP26 beckons, we want to see increased ambition right across the world in terms of nationally determined contributions to get emissions down. We also want to work with big developing countries such as India and China, with the technology and the innovation that the UK is particularly adept at providing, to help them to transition to a greener economy.

Philip Dunne: Following the acquisition by Turkey of certain key military equipment from Russia, what is my right hon. Friend doing to try to maintain strong bilateral relations with Turkey as a key NATO ally?

Dominic Raab: My right hon. Friend is absolutely right—we have, as I mentioned, expressed our concern to Turkey about its acquisition of Russian-made weapons. That is against not just the letter, but the spirit of NATO. Equally, we value Turkey as a trusted NATO ally. It is often on the frontline of some of the greatest challenges that the alliance faces, so we are working with Turkey and all the European and North American partners to try to bring it into the fold and make sure that it is focused on NATO’s priorities.

Kevin Brennan: I think the Foreign Secretary inadvertently said that the Prime Minister was launching the COP26 plans with Richard Attenborough today, but of course he is no longer with us. He might want to take the opportunity to correct  the record.
Will the Foreign Secretary consider the request I made earlier through his colleague to meet my constituent, Robert Cummings, in relation to the case of Luke Symons in Yemen?

Dominic Raab: I am happy to correct the record as to which Attenborough I meant. We are lucky to have had so many fantastic Attenboroughs in this country. I also repeat that we are ambitious for COP26.
Of course, I will look carefully at the case the hon. Member raises. In all these consular cases, we want to provide the most effective representation to secure people’s release and to provide the reassurance they need and comfort to the family.

Desmond Swayne: What proposals has the Minister for the Wilton Park conference on Nigeria later this month as regards reducing the persecution of Christians in that country?

Andrew Stephenson: As my right hon. Friend knows, we take freedom of religion and belief extremely seriously, and the Prime Minister’s envoy, my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti), is working closely with me on the plans for that conference.

Universal Credit: Delayed Roll-Out

Lindsay Hoyle: We now come to the first urgent question, which I expect to run for 45 minutes.

Neil Gray: (Urgent Question): To ask the Secretary of State for Work and Pensions to make a statement regarding the delay to the full roll-out of universal credit.

Will Quince: The Secretary of State and I informed Parliament yesterday that we had revisited our forecast for universal credit and were extending its completion date to 2024. Our planning for universal credit relies on assumptions about the number of people whose circumstances will change each day, thereby naturally migrating. Our forecasts to date have relied on 50,000 households experiencing a change in circumstances each month. Based on this, we had predicted that the process of natural migration to universal credit would be completed by December 2023.
Information collected on changes to people’s circumstances suggests that natural migration is happening less frequently than we expected. This suggests broad stability in people’s lives and can be attributed to a number of reasons, including the robustness of the labour market. We now estimate that 900,000 fewer households will naturally migrate between now and December 2023 than we had forecast. Given that we expect to manage about 100,000 households to universal credit each month, it necessarily follows that if we are to protect the interests of claimants and move them to universal credit safely it will take a further nine months to complete the implementation of universal credit.
I can assure colleagues that claimants will not lose money from their universal credit award owing to this forecasting change. We will always put the best interests of our claimants first, and as we move into the managed migration phase protecting the vulnerable will be our utmost concern.

Neil Gray: Thank you, Mr Speaker, for granting this urgent question, which I believe is the first to be granted to the SNP under your speakership.
The UK Government still have no respect for the House. They let the BBC announce this delay as part of a news trail for the documentary being aired tonight, without a written ministerial statement—I have not seen one, so can the Minister tell the House where it is?
I feel for the Minister, being forced to stand here today, because I know it was not his decision to withhold that information from colleagues. Where is the Secretary of State? This should have been an oral ministerial statement.
Quotes from the documentary seem to suggest that this decision was taken by a senior official, not the Secretary of State. Has she abandoned decision-making oversight? When did she sanction this decision? Perhaps there was no oral ministerial statement because she found out only last night, like the rest of us—what an absolute shambles.
Universal credit was supposed to have been fully rolled out by 2017. This further delay means that it will have been delayed by a further seven years at a potential cost of £500 million. It highlights how far universal credit  is from getting it right, as does the fact that this delay is needed to avoid further hardship to those in receipt of the benefit.
Ministers say, as the Minister said again just now, that the delay is needed because people are scared to go on universal credit. They say it like they are actually surprised. The great irony is that if this Tory Government were to listen and do what expert charities and those actually in receipt of universal credit were saying, these delays would not be needed.
Will the UK Government use this delay productively by making a meaningful investment in universal credit to see it fixed, scrapping the two-child cap and rape clause, ending the debt and poverty-inducing five-week wait and making work pay by fully restoring work allowances?
Finally, will the Minister confirm that this delay means that more people will be part of the natural rather than the managed migration process, which in turn will mean that those recipients will lose out on transitional payments, thus saving the Government more money at the expense of people who actually need it?

Will Quince: I have not yet seen the BBC documentary, and I suspect that the hon. Gentleman has not done so either, because it is due to be aired shortly. However, it is important to stress that officials discussed advice to be sent to Ministers late in 2019, and the final discussions were held with Ministers in 2020. Parliament was then informed. This relates to the back end of the timetable, which concerns people moving to universal credit in 2024-25, so the change was communicated in good time.
The hon. Gentleman referred to cost, and it is important to put that in context. This is additional money that will go into the pockets of our claimants, some of the most vulnerable and disadvantaged in our country. About 900,000 people could now receive transitional protection who would not have been able to receive it through natural migration.

Damian Hinds: I welcome my hon. Friend’s clarification of the need for this reforecasting. May I invite him to restate the Government’s total commitment to a universal credit arrangement that simplifies the system? It means dealing with one Department rather than three, it combines six benefits into one, it helps people to get into work more quickly, and it smooths their transition into work thereafter.

Will Quince: I thank my right hon. Friend for his question, and for all the work that he did in our Department. He is absolutely right: universal credit is a modern, flexible, personalised benefit that reflects the rapidly changing world of work. Conservative Members believe that work should always pay, and that we need a welfare system that helps people into work, supports those who need help, and is fair to everyone who pays for it.

Margaret Greenwood: Yesterday the BBC reported that the Government had decided to delay the roll-out of universal credit until September 2024, adding £500 million to its overall cost. That is hugely embarrassing for the Government: yet again, they have had to delay what is meant to be their flagship social security policy. Last week the Minister told the House that they had managed to process fewer than  80 households since July, as part of what was meant to be a pilot of up to 10,000 households in Harrogate, and that only about 13 of those households had transferred to universal credit. At that rate, it would take the Government more than 380 years to complete their managed migration pilot.
Universal credit was supposed to make work pay, but instead it has caused misery for thousands across the country. It seems from yesterday’s report that senior civil servants think people are too scared to transfer to it. Can the Minister tell us why so many people are scared? Is it because of the five-week wait that is pushing so many families into debt and rent arrears, and making them turn to food banks to survive? Is it because of the two-child limit, which the Child Poverty Action Group has described as
“a policy designed to increase child poverty”?
Is it because of the sanctions regime that has made some of the most vulnerable people in our society destitute? Or is it down to the fact that, according to the Government’s own research, nearly 50% of claimants were not able to make a claim online unassisted?
It is clear that the Government have been forced to delay universal credit yet again because people do not have confidence in the system. Can the Minister tell us what they intend to do with the extra time? Will they get rid of the five-week wait? Will they scrap the two-child limit? Will they call a halt to the sanctions regime that is pushing people into destitution? And will they now apologise to all the people whom they have pushed into hardship through universal credit, and create a social security system that protects people from poverty and treats them with respect?

Will Quince: The hon. Lady says that I should be embarrassed. I will never be embarrassed about putting the most vulnerable and disadvantaged people in our society first, and neither will the Government. She talked about cost. As I have said, this is up to £500 million of additional money that will go into the pockets of our claimants. When she referred to the pilot, she was conflating two very separate issues. She also said that people were scared. Perhaps if members of the Labour party desisted from their scaremongering and spent more time in our jobcentres speaking to work coaches, they would have a better understanding of universal credit and how well it is working.

Stephen McPartland: I am certainly no fan of the Department for Work and Pensions and its campaign to improve universal credit, but I do know that this Minister cares about making universal credit work, and this Minister has my full backing to make it work—and I have worked with many Ministers over the last 10 years. Will he tell me clearly, however, whether my constituents will be better off or worse off because of the way in which the migration works?

Will Quince: I thank my hon. Friend for his question and for his kind words. The answer is a categorical yes: his constituents will be better off. Under our forecasting, around 900,000 people will now be eligible for transitional protection, and as a result they will be better off.

Stephen Timms: I congratulate the hon. Member for Airdrie and Shotts (Neil Gray) on securing this urgent question. Claimants are extremely  reluctant to be moved on to universal credit. It has a dreadful reputation, largely because for the first five weeks that they are on it the only help they can get is a loan. Claimants on universal credit are two and a half times more likely to need a food bank than those on the previous benefits. Will Ministers look urgently at drastically cutting that five-week delay?

Will Quince: First, I congratulate the right hon. Gentleman on his election as Chairman of the Work and Pensions Committee. I take all issues around policy in my Department, in the areas in which I have control, very seriously and I am happy to work with him. Are there improvements that we can make to universal credit? Yes, of course there are, and I look forward to working with him find some of those solutions.

Mark Harper: Is the Minister as surprised as I am that, when questions about universal credit come up, people have a clear tendency to forget that the legacy benefits system leaves a lot to be desired and traps people in jobs where they cannot work more hours? Universal credit is a massive improvement. Of course there are going to be issues, but I for one am pleased that the Minister is taking this cautiously and carefully. Universal credit helps people to get into work and makes work pay, and he should not be embarrassed about it at all.

Will Quince: I thank my right hon. Friend for his question. The previous system has been described as clunky and confusing, as leading to overpayments and therefore ongoing deductions, as acting as a disincentive to work through cliff edges at 16, 24 and 30 hours, and in some cases as a marginal tax rate of 90p in the pound. Labour was content to have people trapped in a life on benefits. What did that mean for the life chances of people and their children? Under universal credit, it always pays to work and increase your hours.

Angela Eagle: The final delivery of universal credit seems to be even later than a Northern train. It is a demonstration of the incompetence of this Government that they have wrecked the benefits system in this way. When universal credit was rolled out in my constituency as one of the experiments—they never do experiments in their own constituencies—it caused a tenfold increase in food bank usage and huge hardship—[Interruption.] The Minister can pretend all he likes that that did not happen, but I know from my own advice surgery that this benefit causes misery.

Will Quince: Let us instead look at the facts. Universal credit will give claimants an extra £2.1 billion a year, once it has been fully rolled out, compared with the system that it replaces. Around 1 million disabled house- holds will receive an average of around £100 more a month, and 700,000 families will get the extra money that they are entitled to—around £285 a month—under universal credit. Claimants will have access to around £2.4 billion of previously unclaimed benefits—benefits that they did not receive under the legacy benefits system of the previous Labour Government.

Michael Tomlinson: I simply do not understand why Opposition Members are so against this system, which is helping  people into work. I have visited my jobcentre in Poole, where work coaches are so positive about the universal credit system because it gives them the tools to get people into work. It is not just Conservative Members who support universal credit; it is also those who have been helped into work by our work coaches.

Will Quince: My hon. Friend is absolutely right, and I thank him for visiting his jobcentre. If more Members across the House did so, they would have a better understanding of the system and of how our work coaches feel about it. They would find that, as my hon. Friend rightly says, it is a valuable tool to help people to get into work and to progress in work. We should all be proud of it.

Hywel Williams: In a written answer to me, the Secretary of State has conceded:
“As the two-child limit policy was introduced in April 2017 there is insufficient data to assess any impacts of the policy on low income.”
Almost three years on, we still do not have sufficient data to assess the impacts. Will the Secretary of State and the Minister take the opportunity provided by this period of grace that they have granted themselves to get proper statistics on the effect of the two-child rule on people of ethnic and religious backgrounds, and at local authority and parliamentary constituency level?

Will Quince: I am not entirely sure about the correlation between that question and this urgent question but, nevertheless, the hon. Gentleman can write to me, or I would be happy to meet him to discuss the issue further. I cannot guarantee that we will agree, but I will be happy to listen to him to understand the issues he raises.

Rachel Maclean: When I visited my jobcentre in Redditch, which, contrary to some suggestions from the Opposition, has had full roll-out of universal credit since October 2017, I found work coaches to be incredibly positive about the transformational help being given to their clients. Does the Minister agree that the constant scaremongering and muddling from Opposition Members is the problem? First they want to scrap universal credit, then they want to pause it—who knows what they would do? We need to be on the side of the people, and I am glad that this Government are.

Will Quince: My hon. Friend is quite right. At every single jobcentre that I visit—I visit one every week on average —I get that same feedback, and the one thing that staff would like to change is the reputation. It would be helpful if Opposition Members visited their jobcentres, spoke with work coaches, got that understanding, and desisted with the unhelpful scaremongering.

Alison Thewliss: My constituent, a mature student with a wife and child, claimed UC and provided all the information that was required. The DWP later announced that it had made an error and asked my constituent to pay back £2,416. He has had to give up his studies, and his family is now in hardship. Does that incompetence not demonstrate why people are so scared to make a UC claim? While  the Minister for deep-fried Mars bars is at the Dispatch Box, will he explain why he still has not apologised to me and my colleagues?

Will Quince: I hope you recall, Mr Speaker, that I did make a full, frank and unreserved apology in this Chamber. As for the case that the hon. Lady raises, if she would like to write to me with the details, I will happily look into it. There are strict Treasury rules about errors and deductions, but I will be happy to look at them.

James Cartlidge: Will my hon. Friend confirm that today’s announcement does not change the fundamental course of our policy, which is to move away from a perverse legacy system that incentivised claimants to minimise the number of hours worked to one that incentivises them to maximise their hours and gives them a chance to move away from long-term benefit dependency?

Will Quince: I thank my hon. Friend for that question and for his support for universal credit and, indeed, his local jobcentre. We believe that work should always pay, and we need a welfare system that helps people into work, supports those who need help, and is fair to the taxpayers who pay for it. It is important to stress—my hon. Friend is right about this—that it always pays to work and increase one’s hours under universal credit. That was not the case under the legacy benefit system.

Yvonne Fovargue: Overwhelming evidence from the pilot areas such as Wigan and debt charities such as StepChange shows that the five-week wait is causing further debt problems. Will the Minister use this delay to rescind and reconsider this policy urgently?

Will Quince: I have huge respect for the hon. Lady, and I would be happy to visit her constituency to meet some of the organisations she references. It is important to state that nobody has to wait five weeks for an initial payment, which can be done on day one. It is repayable over 12 months but, as of next year, that will be extended to 16 months. We also have additional measures such as the two-week housing run-on and, as of July this year, a further two-week run-on of other legacy benefits. Are there further improvements that I would like to make? Yes, of course there are. They would all require Treasury approval, but I would be happy to work with hon. Lady to look at them in further detail.

Richard Drax: I, too, have visited my jobcentre and its staff universally welcome universal credit—there is no doubt about that—but there have been one or two hiccups. When an employer tends to pay early, say at Christmas, that does tend to muck up the next month’s universal credit payment. Are we trying to resolve that issue?

Will Quince: My hon. Friend asks a pertinent question that was raised by six separate colleagues at oral questions only last week. I am looking closely at this area and intend to organise a roundtable with interested colleagues and officials to explore how we can tackle the issue.

Debbie Abrahams: I congratulate my hon. Friend the Member for Airdrie and Shotts (Neil Gray) on his urgent question. Policy in Practice analysis shows that disabled people  lose an average of £3,000 a year, but they are not the only group to lose money under universal credit. In addition to considering the five-week wait, about which so many of my colleagues have raised issues, will the Minister examine increased support for disabled people? Disabled people and children are being plunged into poverty as a result of this benefit.

Will Quince: I think I have already answered this question. Around 1 million disabled households will receive an average of £100 more per month under universal credit. Importantly, the claimants will have access to around £2.4 billion of previously unclaimed benefits that, for all sorts of reasons, they did not claim under the legacy benefit system.

Andrew Jones: Harrogate and Knaresborough has been a trial area for universal credit since it started, including being the location for the legacy migration. I have therefore followed universal credit for many years and I have spoken with claimants, employers and the team at Harrogate jobcentre who have done a great job. They all report positive feedback. There are obviously some problems, but there were problems with the previous system. Universal credit is helping people to get into work and to make work pay. Will the Minister continue the focus on making work pay?

Will Quince: I thank my hon. Friend for his very helpful question and for his support of universal credit and his local jobcentre. I am full of praise for those staff working in the jobcentre at Harrogate and the work that they are doing on the pilot. That is hugely important work, because it sets the scene and gives us the all important data and learnings we need to move out universal credit at scale and pace.

Janet Daby: In the last 18 months, a food bank in my constituency has seen an increase of two thirds in people using it. Will the Government accept that more people in the UK—including those in employment—are using food banks than ever before, as a direct result of policies such as universal credit, the five-week wait and the two-child limit?

Will Quince: I do not want anyone in our country to have no choice but to use or visit a food bank. I visit food banks regularly, and I want to get a clear understanding of food insecurity in our country. That is why we have commissioned questions for the Family Resources Survey, which started in April last year. I am also working with food banks and other organisations that tackle food insecurity to better understand the issue. If we better understand the issue, we will know how to tackle it.

David Simmonds: Does my hon. Friend recognise as I do that the opening of the food banks that serve my constituency in 2009 was a response to the deep-seated problems at the height of Labour welfare spending? Does he agree that the feedback from local authority areas where universal credit has been rolled out has been that it is a much more supportive system than the legacy system?

Will Quince: I thank my hon. Friend for that question. He is absolutely right: it is a far better system than the previous legacy benefit system. We know it is working  better at helping people to get into jobs and stay in them. Is it any surprise that under this Government the number of people in work is up more than 3.8 million since 2010, and the employment rate is 76.3%, a record high?

Kate Green: Given this latest delay, which follows endless repeated delays over the last few years, can the Minister assure the House that sufficient investment is being made to maintain the legacy systems, which will now have to last an additional seven and a half years longer than originally envisaged?

Will Quince: I can of course give that commitment, but I stress that this is a change in policy based on forecasts. Forecasts do change, and it is responsible of Ministers to look at them and change policy accordingly. If the forecast changes, I will of course look at it, as will the Secretary of State, and where necessary, act accordingly.

Siobhan Baillie: We hear a lot from the Opposition, and we certainly did during the election, about scrapping universal credit or sections of it, but I and many people in this Chamber would much rather have a change of forecast than a change to the entire system, and certainly the jobcentres would agree with that. Will the Minister tell us what, if anything, claimants will notice on the ground from the change in forecasts?

Will Quince: I thank my hon. Friend for that question, and I welcome her to her place and indeed to her position on the Select Committee. Most claimants will not notice any difference whatever, other than that an extra 900,000 will be eligible for transitional protection. She raises an important point. The IFS slammed Labour’s pledge to scrap universal credit as uncosted and
“unwise…expensive, disruptive and unnecessary.”
It is important to point out that no Labour Government have ever left office with unemployment lower than when they started.

Chris Stephens: The Minister is correct that he apologised to Glasgow MPs, but he told us he would write to us that day and we are still waiting. Delays seem to be an important part of his stewardship.
On the five-week wait and given that we now know from parliamentary answers that the Department receives £50 million a month in repayments from advances, surely that now tells us to scrap the five-week wait and make sure the first payment is not a loan or an advance payment, but a first payment for universal credit.

Will Quince: It is a system based on arrears, not on advances, unlike the legacy benefit system. The hon. Gentleman knows that people are able to access an advance on day one repayable over 12 months. That will extend to 16 months next year and I am looking at whether we can explore options to extend that further. We have made further changes—scrapping the seven-day wait, the additional two-week run-on, the two-week run-on starting in July of legacy benefits—and, where there are further changes we can make, I am of course willing to look at them and act where appropriate.

Peter Aldous: I commend the Government for delaying the roll-out of universal credit and, indeed, for the changes that they have made to the system over the last four years or so, but may I ask the Minister to give serious consideration to getting rid of the five-week wait, notwithstanding the answer he gave to the hon. Member for Makerfield (Yvonne Fovargue)? In my experience, it is causing very serious challenges for my constituents.

Will Quince: I thank my hon. Friend for his question and the constructive way in which he put it, but I must respectfully disagree with him. There is no five-week wait. People are able to access their advance on day one.

Sarah Olney: Can the Minister tell us whether we can now expect to see an improvement to the kind of delays that many applicants are experiencing in their applications being processed? Will the Minister commit himself to publishing some statistics so that we can see whether the impact of this delay has resulted in an improvement to those kinds of delays?

Will Quince: I am a little confused, because my understanding is that those performance stats are indeed available. The Department has a very good record on payments and payment timeliness. Can we improve? Of course we can, and I meet with officials on at least a weekly basis to discuss that. In many cases, it is down not just to the Department but to how the claimant provides information. We are putting in additional resource, where appropriate, to help people to help themselves to get us that important information that we need to process the claims.

Nigel Mills: Will the Minister confirm that one solution to this would be to get more uptake for the excellent help to claim service through Citizens Advice? Will he confirm that service will be extended so that it is there for the whole period through to the end of the roll-out?

Will Quince: I thank my hon. Friend for that question and for his work on the Select Committee. He is right: help to claim, commissioned via the Department and run by Citizens Advice and Citizens Advice Scotland, is working really well. We are now in detailed discussions in relation to a second year, but I want to go further and in April we will launch a £10 million transitional fund for UC, in particular to support disadvantaged and vulnerable groups. It will also help Members, because organisations in their constituencies will be able to bid for that funding.

Meg Hillier: The Public Accounts Committee is not in the business of scaremongering, but from the very beginning we have raised concerns about the pace and the over-ambitious nature of this policy. Only today, the Minister listed so many changes that have taken place since it was rolled out that it shows there is a problem. In our last session on this issue, we heard from local authorities about the millions of pounds they are having to put aside to help people. With this extra time, will he look at what support he can give local authorities who are having to backfill mistakes by his Department?

Will Quince: Universal credit is an evolving system and it is a relatively new system. I meet with stakeholders and Members from both sides of the House on a regular basis, and where there are improvements that we can make quickly, I will of course look at them and make them. Where there are changes that can take a longer period of time, I can start setting those in train. I would be very happy to meet the hon. Lady and discuss the issue she raises in further detail.

Rob Butler: One of the very first constituency visits I made as a new MP was to Aylesbury jobcentre. Does my hon. Friend agree with me, and with the work coaches and claimants I met there, that universal credit is a much better system than what went before because it positively incentivises people to find a job?

Will Quince: My hon. Friend is right for all the reasons that he points out, but I would go further and say that it is the personal relationship with a work coach that makes it so very different to the legacy benefits system. Work coaches will work with people to help them get work ready, to get into work and then to progress into the job that they want and that suits their family.

Mark Hendrick: My constituency was one of the trials for universal credit, and all we have seen since its introduction is debt, poverty, hunger and homelessness. How is that putting the claimant first?

Will Quince: I do not recognise those statistics, or indeed the correlation. I do not know when the hon. Gentleman last visited his jobcentre, but I would strongly recommend he does so to discuss with work coaches the difference that universal credit is making in his constituency. If he has specific concerns, I invite him to write to me and I will look at them in detail.

Andrew Bowie: Does my hon. Friend agree that if people out there are scared, the blame, at least in part, is with the Opposition parties, whose reckless, irresponsible scaremongering paints a picture wholly at odds with the picture on the ground in jobcentres across the UK?

Will Quince: My hon. Friend raises a good point. When I speak to and visit jobcentres and work coaches, they always tell me that the one thing they want to change is reputation. While Opposition Members continually talk down universal credit and say they would scrap it—against the advice and guidance from organisations such as the IFS and many charities—they are not helping the situation a jot.

Steve McCabe: If I accept that part of the Minister’s motivation is to protect the interests of those on legacy benefits, will he equally accept that those who are wrongly transferred to universal credit because of erroneous advice from a jobcentre, should have their interests protected by an automatic right to at least have their legacy benefits restored?

Will Quince: The hon. Gentleman raises a pertinent point. I am looking at that very issue. I would be happy to meet him to discuss it further; it does concern me.  On his first point, I will always put disadvantaged and vulnerable residents at the forefront of my mind in any decision making that I undertake while in this role.

Stephen Crabb: The Minister is exactly right in the careful, pragmatic approach that he is taking to roll-out; it is what responsible Ministers do. However, may I encourage my hon. Friend to follow his instincts and, in his discussions with the Treasury, make the case for improving universal credit? The truth is that if we are to improve this good policy further, it will require resource.

Will Quince: I thank my right hon. Friend for his helpful question and for all the work that he did while at the Department. He, like me, believes that work should always pay, and that we need a welfare system that helps people into work. My mind is full of ideas on how we can improve universal credit, and if he would like to help me in persuading the Treasury to get behind those, I would very much welcome that.

Stephanie Peacock: Barnsley food bank gave out over 4,000 food parcels to people in crisis in a year. The Minister appears to be in complete denial. Why will the Government not accept that the increase in food bank use has a direct link to policies such as universal credit, and that it is about time it was scrapped?

Will Quince: I thank the hon. Lady for her question. I could not disagree more, but I do agree with her that I do not want to see anybody feeling that they have no choice but to visit a food bank. I want to better understand this issue, which is why I visit food banks. I meet food bank organisations and other organisations that help to tackle food insecurity. I would be happy to meet the hon. Lady to discuss this further. There is a huge amount of ongoing work.

Steve Double: I very much welcome the approach that the Minister and his predecessors have taken on this issue, keeping universal credit under review and making changes where appropriate, but can he assure me that some things about universal credit will not change—that it will always be a system that is fair to claimants and the taxpayer, and that being in work will always pay?

Will Quince: I can absolutely give my hon. Friend that assurance. Under universal credit, it will always pay to work and it will always pay to do more hours. That is the principle that we stand by, and we will stick by it.

Drew Hendry: My constituency was the guinea pig for universal credit, and we had no protection over our transition. By 2024, Inverness will have endured 10 years of chaos, delays and hardship. What will the Minister do to compensate those claimants who have already been through this mill, and will he do something about repaying the £3 million in additional administration costs that Highland Council has incurred in order to operate universal credit?

Will Quince: First, I do not recognise the statistics and figures that the hon. Gentleman raises. I feel that he has a permanent prejudice against universal credit in  principle. If he would like to write to me with any statistics or figures that support his claims, I would be happy to look at them.

Neil Coyle: The Minister accuses charities of scaremongering, but are not people right to fear the debt, poverty, food bank reliance, homelessness and even survival sex work that universal credit and the five-week wait have been evidenced to create—even seen by the Work and Pensions Committee?

Will Quince: I have worked very closely with the hon. Gentleman on issues such as homelessness. He knows that I share his passion to ensure that our welfare system works, and supports the most vulnerable and disadvantaged in our society. However, it is important to point out that we spend £95 billion a year on benefits for working-age people, so we will continue to reform our welfare system so that it encourages work while supporting those who need help—an approach that is based on the clear evidence that work offers families the best opportunity to get out of poverty.

Zarah Sultana: On Friday I visited Coventry food bank, where demand has shot up in the past few years. I asked the staff why. Their answer was immediate and unequivocal—universal credit. Will the Government finally accept that many more people than ever before, many of whom are in employment, are using food banks as a direct result of universal credit, the five-week wait and the two-child limit?

Will Quince: I thank the hon. Lady for her question but do not accept the anecdotal points that she makes. Governments and Ministers make and take decisions based on evidence. I am building the evidence base within the Department based on the family resource survey and the questions in it in relation to food insecurity, and working with food bank providers—the Trussell Trust being one, but there are around 800 independent food bank providers—to better understand the issues and how we can tackle food insecurity in the round and for good.

Steven Bonnar: This Government need to take a long, hard look at themselves and the pressures they are placing on hard-working, low-income families and individuals. I do not trust the Minister’s pledges. For a hard-working, loving parent, it is absolutely, gut-wrenchingly worrying—which is no doubt beyond the comprehension of many of the privileged folk of this place—to find out that the moneys they are depending on, and entitled to, will not be coming. I do not need to visit a jobcentre to know that; I speak with some authority on the matter, because until my election to this place, I was a universal credit claimant, as a single parent. I ask the Minister to scrap the five-week wait and stop plunging hard-working families and individuals into further debt by making it necessary for them to avail themselves of a loan from the DWP.

Will Quince: I thank the hon. Gentleman for his question. I would suggest very strongly that he should visit his local jobcentre, because he would have a better understanding. [Interruption.]

Lindsay Hoyle: Order. Peter Grant.

Peter Grant: Will the Minister reconsider the ill-advised and, frankly, insulting use of the word “scaremongering”? It is not scaremongering when food banks talk about a massive increase in demand, and when local authorities report huge increases in rent arrears; nor is it scaremongering for local authorities to report having to spend a lot of their scarce resources to make up for the shortfalls of universal credit. If the Minister wants to insult me by accusing me of scare- mongering, that is fair enough; when he insults me for raising the concerns of my constituents, he insults my constituents. Will he apologise for that, and will he reconsider the inflammatory language he has used?

Will Quince: I meet stakeholders in relation to the Department every single week, and I take the concerns and issues they raise very seriously because they are largely based on evidence. When I refer to scaremongering, I refer to the tone and language and rhetoric so often used by Opposition Members.
I did not quite get to answer the question by the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) and in fairness, I should. He mentioned hard-working people. It is important to stress that income inequality has been falling under this Government in real terms. The national living wage will rise to £8.72 in April, and to £10.50 by 2024. Our tax changes will make a basic rate taxpayer more than £1,200 better off. We have doubled the free childcare available to working parents. We are doing a huge amount to tackle the cost of living and to support working parents.

Barry Sheerman: I think the Minister is quite a fair-minded man, but does he agree that the best policies for our welfare state are evidence-based? That means not just visiting constituencies and looking at jobcentres, but looking at the health sector. Ask GPs; ask the people running our hospitals and healthcare. They will tell us, and him, the real impact on people’s health up and down the country as one of the side effects of this silly, misguided policy.

Will Quince: I meet all sorts of organisations up and down the country, and they often raise some of the issues that the hon. Gentleman raises. Where there are issues with our system that I can make changes to quickly, I look at them, and if they do not have a huge fiscal impact, I will make them. Otherwise, we have to look to fiscal events. However, universal credit is an evolving process. If there are improvements that we can make—and I believe that there are—we should make them. I am looking at those very closely; if the hon. Gentleman has ideas, I would be happy to hear them.

Alan Brown: The National Audit Office has said there is no evidence that universal credit gets people into work, and that there is no way of measuring it from the Government’s perspective. The roll-out of universal credit in my constituency has caused council housing rent arrears to double, so that is putting a burden on local rent payers. In November 2018, income assessment period deductions for people getting two pay packets were found to be illegal. The Minister says he has lots of ideas to improve universal credit; can he give us an idea to improve at least one of those aspects?

Will Quince: Let us look at some facts: the number of people in work has increased by more than 3.8 million since 2010; the employment rate is 76.3%, which is a record high; the unemployment rate is 3.8%, having gone down by more than half since 2010; and 80% of the growth in employment since 2010 has been in full-time work. We are very proud of our record, but we are not complacent and our ambition is to go much, much further.

Alex Cunningham: Perhaps if the Tory MPs had my case load, they would recognise the misery and poverty that their policies caused. This week, another constituent contacted me because she had been denied the vital UC cash she needs, as she is paid four-weekly and this last month she received two payments from her employers. When will this anomaly be sorted out and people not be left unable to pay their bills?

Will Quince: I believe I answered this question a little earlier today. I am looking at the issue, and I will invite the hon. Gentleman, along with other colleagues who have an interest in this area, to the Department to raise it with officials. We are looking at solutions. It is not potentially an easy or quick fix, but if we can address this, of course we will.

Jim Shannon: I see the delay as a wise step by government to reassess, and I congratulate the Minister on not enforcing a transfer to UC on people, who know it will see them in a five-week freeze. Will he use this delay to introduce a smoother, more workable transition period, to prevent people from getting into debt?

Will Quince: I thank the hon. Gentleman for that question. The important point here is that when we talk about the £500 million cost, we are talking about £500 million that will go into the pockets of claimants up and down the country, including some of the most vulnerable and disadvantaged people in our country, who previously would not have received that transitional protection under the legacy benefits system or in their transfer over under natural migration.

Martin Docherty: Although I would visit jobcentres in my constituency on a more regular basis, it does not help when the Department shuts them, as it did the one in the Vale of Leven. Given a substantial increase in the uptake of support through the two food banks, Food for Thought and West Dunbartonshire Community Foodshare, although we may disagree on the implementation, I hope the Minister takes the opportunity to agree with me that with this extension and additional moneys going into the process there is an opportunity to reflect on what has gone on before, especially for those Members, such as myself, whose constituents do not feel as though they have been treated properly.

Will Quince: We have more than 630 jobcentres up and down our country, so there will be a jobcentre within reach of the hon. Gentleman. He raises a number of points. We are always looking at how we can improve UC, and if he has ideas, he can either write to me or come to see me, because I am very approachable—we could even share a deep fried Mars bar together.

Desmond Swayne: No one should agree an embargo with the BBC and expect it to be kept, should they?

Will Quince: It is probably best that I do not comment on this. We had intended to come to this House this week to announce this. Unfortunately, we got this done yesterday via a letter to the Work and Pensions Committee Chair and indeed a “Dear colleague” letter to myself, and I am here today to answer Members’ questions, which I hope has been valuable.

Lobby and Media Briefings:  Journalists' Access

Tracy Brabin: (Urgent Question): To ask the Chancellor of the Duchy of Lancaster if he will make a statement on the barring of certain journalists from official civil servant media briefings at the direction of special advisers and the arrangements for future lobby and media briefings.

Chloe Smith: Thank you, Mr Speaker, for the opportunity to clarify this situation. This Government are committed to being open in their dealings with the press and to the principles of media freedom, and the events of yesterday were a good example of that. The Prime Minister delivered a speech on the future of the UK-EU relationship. He also took extensive questions from journalists. Following that, there was a further briefing for journalists by the Prime Minister’s official spokesperson, which was made available to any journalist who wanted it directly after the speech and was all on the record.
Lobby briefings typically take place twice a day. All those with a Press Gallery pass are able to attend these briefings and to question the Prime Minister’s official spokesperson however they wish. No journalists are barred from official media briefings hosted by the Prime Minister’s official spokesperson. It is entirely standard practice for the Government to host additional technical, specialist briefings, as was the case yesterday. This particular briefing, which the media have reported on, was an additional, smaller meeting due to be held by a special adviser in order to improve the understanding of the Government’s negotiating aims for the future relationship. I am delighted that there are so many right hon. and hon. Members here today who would also like to improve their understanding of such things.

Tracy Brabin: Thank you, Mr Speaker, for granting this timely and important urgent question. The ability of the lobby to have access to briefings without favour is a long-standing tradition, and one vital to the health of a functioning democracy. Yesterday, certain publications were barred from a briefing on future trade deals with David Frost, the Prime Minister’s adviser on Europe. According to reports, when journalists from other news outlets arrived, the Prime Minister’s director of communications, a special adviser, said:
“Those invited to the briefing can stay—everyone else, I’m afraid, will have to leave.”
When challenged, he added:
“We’re welcome to brief whoever we like, whenever we like.”
The code of conduct for special advisers states that
“special advisers must not: ask civil servants to do anything which is inconsistent with their obligations under the Civil Service Code”.
On the David Frost briefing yesterday, will the Minister tell us who decided which journalists could attend and what the selection criteria were? If that decision was made by a special adviser, are they in violation of both the code of conduct for special advisers and the civil service code? Can she confirm whether civil servants were in attendance?
Sadly, yesterday was not an isolated incident; the Huawei briefing last week was exactly the same. I understand that that was given by Ciaran Martin of the National Cyber Security Centre, plus civil servants from the Foreign and Commonwealth Office and the Department for Digital, Culture, Media and Sport. So will the Minister tell us who decided which journalists could attend and what the selection criteria were? If that decision was made by a special adviser, are they in violation of both the code of conduct for special advisers and the civil service code? In addition, where is the reply to the letter to the Cabinet Secretary Sir Mark Sedwill reported in The Times, as, apparently, he does not have “a problem” with this? Can the Minister confirm what the Cabinet Secretary’s advice is and whether he believes there have been breaches of the special adviser code of conduct in either case?
Finally, on 13 January the editors of those national newspapers, with the Society of Editors, wrote to the Prime Minister, but we still do not have the reply. When was it sent? Has it been written? The Government’s behaviour in these matters threatens the civil service’s core values of impartiality and objectivity. It also brings into question the integrity of future Government media briefings and the conduct of their special advisers, and it damages a free and vibrant press, which is central to this parliamentary democracy.

Chloe Smith: I am more than willing to repeat the points I made, which were that this briefing was additional to normal lobby handlings. Those lobby handlings are entirely normal, standard and routine, and have been so over successive Governments. I am not taking any further lectures from the Labour party, which needs to look in the mirror a little on this. The hon. Lady is part of a shadow Government who wish to regulate and introduce Soviet-style licensing of newspapers; and whose leader and shadow Chancellor take money from media organisations, such as Press TV, which are owned by foreign, hostile Governments. Under that culture, a BBC editor had to have protection at the Labour party conference, and the shadow Chancellor encourages direct action against journalists who do not write what he likes. Conservative Members strongly support the free press. I have set out the ways in which we do that. In addition to the briefings and the very normal routine operation of the lobby, the Prime Minister has a huge amount of further appointments and engagements on a range of channels. For example, he did more than 120 media engagements during the election. Senior members of the Government come to this House to answer those questions again, and we intend to continue doing those things. That choice is absolutely clear, and we on this side of the House stand up for a free and vibrant press. The hon. Lady needs to ask herself and her colleagues the same questions.

Peter Bottomley: I do not think that anything has happened so far that matches what Alastair Campbell did in trying to get political editors sacked and saying that the then Government would not co-operate at all. It would be sensible for the Government to consider talking to the senior political editors who walked out, to see whether there is a way of getting over this problem and resolving it. Much of what my hon. Friend has said is fine, but the last bit  leaves unresolved problems. There is no greater competition for an MP trying to get themselves into the media than from media people trying to get themselves reported and on air, but they walked away from it, so there is a problem and it needs solving.

Chloe Smith: I am extremely grateful to my hon. Friend the Father of the House for his wisdom and long sight on this issue. He shares with us exactly what these things looked like over successive Governments, which is to say that it is quite routine for there to be lobby briefings on a regular basis—we run them twice daily—and in addition to that some specialist and technical briefings. I understand the point that my hon. Friend closed his contribution with and am sure that that will be correctly considered. It is so valuable that we hear from him, given his long sight on this issue, which reminds us how these things look over history.

Pete Wishart: What the hon. Lady said is woeful and desperate. It makes Comical Ali look like a Pulitzer prize winner. Yesterday was a black day for press freedom and no amount of sleekit, self-justifying nonsense from the hon. Lady is going to get her off the Trumpian hook. The next thing will be the Prime Minister talking about fake news and banning broadcasters—oh, wait: he already has. Just how sinister can it get? The names of journalists were read out and groups assembled on either side of a rug before it was announced who would have access and who would be excluded. No Scottish media outlets were even told about the briefing. I congratulate all the journalists involved yesterday for showing solidarity with their colleagues and refusing to participate in that circus. We know that the Prime Minister dislikes scrutiny and actively hides from the press; we know that Dominic Cummings and his henchmen have their own agenda and are actively trying to bypass and diminish the media; and we all know that the Prime Minister looks like a prize buffoon under the hard questioning that he does not like. Is that not the real reason why we have this particular agenda, Minister?

Chloe Smith: The short answer to the hon. Gentleman’s question is no. The longer answer is that he, too, should be careful about what he says. If he wants to hand out prizes, perhaps he might look back to the days when Alex Salmond, formerly of this parish, used to routinely exclude journalists from his briefings. There is a tinge here, Mr Speaker, of people who are not willing to look at their own record before they come here and prance around with a few too many adjectives.
The other thing I would add is that we on the Government Benches, like others in other parties, are proud Unionists. We recognise that there are national broadcasters that deal with all parts of our country. Long may that last.

Damian Green: There clearly do need to be better arrangements for lobby briefings than was the case yesterday, but I detect the faint air of fake outrage. When I was a journalist, I regarded it as my job to talk to the people who could tell me what I needed to do to provide the story. Indeed, when I was a Minister, if I wanted to talk to individual journalists, there were ways of doing so that might be useful to me and to the individual journalists. I agree with the Father of the House that there need to be improvements in the system,  but does my hon. Friend the Minister agree that what we are seeing here is some fake outrage and a mass outbreak of snowflakery?

Chloe Smith: I am grateful for that view from a senior Member of the House. My right hon. Friend is correct: what we are seeing here is a very normal operation whereby a specialist briefing is offered. That is a good thing, and we are doing that to support the other ways in which we are already an extremely open and accessible Government, providing briefing and access through a range of channels so that people can be well-informed.

Jo Stevens: Mr Speaker:
“Attacks on media freedom are attacks on human rights…Too often, it is governments who are the source of threats to media freedom. Governments—which are responsible for protecting human rights—instead are the ones to violate them.”
Those are not my words, but words taken directly from the global pledge on media freedom that was signed last July by the then Foreign Secretary, the right hon. Member for South West Surrey (Jeremy Hunt). The Minister clearly does not understand what media freedom means; does she understand what hypocrisy means?

Chloe Smith: I do not think the hon. Lady understands that her party has been the worst of all on this point. Her party is the one that has offered to open up journalists’ tax returns and has had to provide bodyguards to journalists. All that is because the leader of her party is of the kind of bent that looks down a camera and says, “Change is coming.” Well, the British people ensured that he was the one who was changed. The hon. Lady should heed that.

Bim Afolami: Will the Minister confirm two things for the House—first, that the Government will of course look at making sure that briefings are done in a sensible way, with the agreement of all members of the lobby over the longer term; and secondly, that this Government and, indeed, this House should always be committed to there being no political interference in our media, because that is a foundation of our democracy?

Chloe Smith: My hon. Friend is right on that point. As I have said, the Government are upholders of freedom and accessibility for Government briefings. We take it as a matter of pride that we are an extremely open Government, ensuring that there are briefings available across a range of channels. As I have already said, what has been happening recently, and the subject of today’s question, is in fact the perfectly normal operation of the lobby: twice daily briefings and, in addition to that, the offer of further specialist briefings. There is clearly the ability to hold the Government to account, and that is how we intend to continue to work.

Tan Dhesi: Does the Minister agree that, unlike what happened in the US, it was brilliant to see our journalists showing solidarity with those journalists who were barred from the briefing and staging a joint walk-out? On another note, does the Minister think that the Prime Minister and his advisers are merely trying to copy President Trump’s tactics and trying to stifle our free press?

Chloe Smith: No, I do not.

Brendan Clarke-Smith: Does the Minister agree that it is ridiculous for the Labour party to pose as champions of press freedom when, as mentioned earlier, the BBC’s political editor has to be assigned a bodyguard to attend the Labour party conference? Does she agree that that is unacceptable and that our press should be able to report without fear?

Chloe Smith: The press certainly should be able to report without fear. We are strongly in support of there being a free press. Let me point to another example, which is that of the Cairncross review. The Government are pressing forward with ways to support our media to adapt to the digital age, and that is in addition to what I have been saying about the way the Government are ensuring that lobby briefings are available.

Joanna Cherry: I congratulate the Minister on the Orwellian double-speak of her opening remarks. I am sure she will go far in this Government.
Those of us who support independent press regulation have, over the years, received a number of lectures on press freedom from those on the Government Benches, so it ill behoves the Minister to dodge our reasonable questions today. She has mentioned how important the Union is to her. I spoke to members of the Scottish lobby about this issue this morning and it is well established that the Scottish media outlets were excluded from the briefing yesterday. Will the Minister clarify a very simple question—was that an oversight or was it deliberate?

Chloe Smith: I have already explained that this particular briefing was arranged to provide further specialist briefing. It was not in itself a matter for the kind of questioning that the hon. and learned Lady is putting about around whether it should be for Scotland or the United Kingdom. That question is rightly subject to a far greater debate on which, I gently point out, she is on the wrong side. The point is that the British people have asked for a clear resolution of our relationship with the European Union. We got Brexit done last weekend and we now move on to the next stage of the negotiation. We all want the lobby to be able to benefit from a good understanding of the negotiating objectives of the UK Government. The UK Government speak for all parts of the UK in that, so such matters are not really the subject of the kind of questioning the hon. and learned Lady is asking after.

Jerome Mayhew: Given that the Labour party called for the resignation of BBC journalists who had the courage to report on antisemitism, does the Minister agree that it is the Conservative party that stands up for a healthy, vibrant and independent press?

Chloe Smith: I welcome my hon. Friend’s contribution. He is absolutely right that what we are talking about here today is how the Government are, ought to be and will be, committed to being open in their dealings with the press and to the principles of media freedom. That is something that we stick by firmly as a matter of principle and of practice.

Thangam Debbonaire: I am really puzzled by what the Minister says, because lobby journalists walked out in solidarity with each other, and they said  that there was no precedent for this, so either they are wrong, or she is wrong. I want to know why she is saying, as she seems to be, that the lobby journalists are wrong, that the National Union of Journalists is wrong, that everybody else is wrong and that this Government are not trying to hide from scrutiny, which is how it appears.

Chloe Smith: I cannot account for the hon. Lady’s understanding, but what I can say is that this Government are making themselves available across a range of briefings and across a range of channels—I have already covered that point—including social media, broadcast channels and innovations such as the people’s Prime Minister’s questions, which is a very good thing. What I can add is that the standard practice of the lobby is that all members with a press pass are able to attend and ask all questions that they would wish to ask. That is how the lobby functions, and we absolutely uphold that. That is happening twice daily and, in addition to that, we are offering further specialist briefings, which is what we are talking about here today.

James Wild: I declare an interest as a former special adviser, most recently in No. 10. I endorse the comments that my hon. Friend has made: there is nothing unusual in providing specialist briefings. Indeed, I was there when we provided one on the Prime Minister’s excellent Brexit deal, which has happily now passed through this House. Is it not important that we keep perspective? In my experience, lobby journalists are well able to look after themselves.

Chloe Smith: I welcome that glimpse of experience. It is important to say again that what we are discussing here today are the normal operations of the lobby. We are making sure that that is supplemented by these additional briefings.

Deidre Brock: These are the words of the Prime Minister in 2017 when he was Foreign Secretary:
“Where governments fear freedom of expression they often try to shut down media and civil society, or clip their wings.”
He also said:
“A free media is vital to creating a vibrant, informed and engaged population and helps to support a safer, more prosperous and progressive world.”
Why does he now think that freedom of the press is important everywhere except Downing Street?

Chloe Smith: Because the hon. Lady is wrongly describing the situation. The Prime Minister stands by those words, as do I.

Dehenna Davison: While the Labour party, true to form these days it seems, is obsessing about the London bubble, will my hon. Friend confirm that the Treasury is looking at how best it can support the media across the country? What impact does she believe that the recently announced business rates relief for local newspaper offices will have, particularly on great Bishop Auckland organisations, such as the Teesdale Mercury and The Northern Echo?

Chloe Smith: My hon. Friend makes a helpful wider point, which is how we, as a Government, can use policy and indeed scrutinise it here in this place—I say  this as the Budget and other such vehicles come up—to look at ways to support the vibrancy of our press and media across the country. I referenced the Cairncross review earlier. These things, together with fiscal measures, are important in that debate.

Chris Bryant: I confess that there is one journalist I would quite like to keep out of Downing Street, but he is the Prime Minister and, unfortunately, he won the general election.
There is a serious issue here: every political generation in government want to try to avoid scrutiny if possible, and it is the job of this House to try to ensure that they do not get away with it. So, all the whataboutery in the world will not stop us complaining when we see a clear pattern of the Prime Minister running his leadership campaign, running his general election campaign and now running the Government in a way that is trying to avoid scrutiny. I am sure that, in private, the Minister would agree.

Chloe Smith: This is simply barking up the wrong tree again. The Government are ensuring that they are open for scrutiny. The Foreign Secretary stood here yesterday and took scores of questions on the very same subject matter. He was again on television shows on Sunday. The Chief Secretary to the Treasury was on a number of programmes yesterday. The Chancellor of the Duchy of Lancaster was out this morning; the Home Secretary was out this morning. The Prime Minister himself took many questions on the subject matter in hand yesterday. Nobody is hiding from scrutiny.

David Simmonds: Does my hon. Friend agree that this very much has the flavour of a storm in a Westminster bubble? Will she outline what further steps she might be taking to improve the ability of our regional and local newspapers to hold all of us as politicians to account, outside of that bubble?

Chloe Smith: This is an important point. As we have already discussed, there are ways to do that, and this Government are committed to them. We have mentioned some points of policy, and we have looked at the business rates point raised by my hon. Friend the Member for Bishop Auckland (Dehenna Davison). To that, I add the way that this Government are making sure that they are available on social media, which, by its very nature, does not require to be inside any Westminster bubble. That is a way for people rightly to be able to hold this Government to account. It is that kind of principle that we hold very highly, and what I have been able to outline today are all the ways in which we are doing that.

Brendan O'Hara: Clearly, the Minister cannot defend what has happened and therefore she is providing a master class in whataboutery. Yesterday, Downing Street announced that there was a new show in town and that it was doing it simply because it can. It was deliberately sinister and knowingly provocative. I am sure that those involved are celebrating the fact that they have an urgent question out of it. What happened yesterday was out of President Trump’s playbook for bullies, and I am sure that those involved are feeling pretty smug about it. Did the Minister and  her colleagues know that this was the type of Government they were voting for when they so enthusiastically backed Boris?

Chloe Smith: The type of Government we are talking about is the type that has just won a resounding majority at a general election and has the support of the people. I think that is a pretty good answer to his question.

Meg Hillier: This does smack of either a deliberate decision to make sure that the mainstream press is being discussed in this way in this House today, or it was just an almighty mistake. Will the Minister, who is a reasonable woman, not use this opportunity to say sorry and that it will not happen again?

Chloe Smith: The hon. Lady takes us on to very, very sober ground, and rightly so. She has great experience as a scrutiniser in this House, but the fact is that that is the wrong characterisation of what has happened. I have set out what the facts of the matter are: what we are dealing with is standard lobby procedures supplemented by an additional specialist briefing. There is nothing more sinister than that, and I think that even she, who is also a very reasonable Member of this Chamber, is just going a little too far.

Daisy Cooper: It is quite extraordinary that the Government say that there is effectively nothing to see here, when the News Media Association and the National Union of Journalists have both said that this potentially represents a threat to the freedom of the press, and both have asked for the Government to consult them on the changes. Once again, the Chancellor of the Duchy of Lancaster and the Prime Minister are missing in action in this House, but I wonder whether the Minister could tell us what action she thinks they would have taken, as former journalists, if they had found themselves excluded from a No. 10 lobby briefing.

Chloe Smith: I think the hon. Lady knows—or she should know, or she will come to know—that, as a Minister at the Dispatch Box, I speak for myself and I do not need to speak for two more senior colleagues. I speak for myself as part of the Government—as part of collective responsibility. Therefore, all Ministers are part of the same message, and that message is absolutely clear here today. It is that we run routine lobby procedures that are more than adequate for ensuring that, if they wish to, everybody with a press pass can ask any question of the Prime Minister’s official spokesperson. That is how that operates, and we are supplementing that with the additional briefings, which I have now mentioned many times. [Interruption.] I am sorry, Madam Deputy Speaker, if this is coming across as boring to some opposition Members, but it is the fact.

Clive Efford: The Prime Minister’s head of communications, who is a political appointee, tried to fix access to a briefing by David Frost, who is a civil service appointee. That is such a breach of protocol that the entire press lobby refused to attend that little soiree. Can the Minister confirm that Sir Mark Sedwill, the Cabinet Secretary, will be investigating this matter?

Chloe Smith: I am afraid the hon. Gentleman has his facts wrong. Mr David Frost is a political appointee.

Alison Thewliss: The Scotsman journalist Paris Gourtsoyannis tweeted that Downing Street did not tell Scottish or regional journalists about the briefing. Can the Minister tell me why she does not value Scottish media? Does she agree that is difficult to report outside the Westminster bubble if the Government do not invite Scottish journalists?

Chloe Smith: I have already answered that point a few times. Again, the answer is that, under the lobby arrangements, any member of the lobby with a press pass is more than welcome to put any question to the Government. That goes for journalists from any corner of our United Kingdom. We on the Government Benches are a Unionist party, and we think that that it should be more than possible to run that kind of practice across the nations of our wonderful country. We welcome close co-operation between the people and the press of Scotland and every other part of our United Kingdom, which I hope will stay united. Again, all of that is supplemented by what we are offering as technical briefings, which I hope can be read as spreading across the Union in that way.

Charlotte Nichols: I was interested to hear the Minister refer to the people’s PMQs on Facebook and engagement on social media as some sort of alternative to proper scrutiny of the Government’s decisions by the press lobby. The Prime Minister cannot even answer what shampoo he uses in the people’s PMQs on Facebook. Why is he running scared?

Chloe Smith: I use Dove shampoo.

Dave Doogan: The Minister has the unenviable task of coming to the House to answer this urgent question, and implying that something that resulted in journalists walking out en masse is perfectly ordinary and nothing to be concerned about. One of her critical defences is, “Well, everybody else did it before we did it, but there’s nothing wrong with it anyway”, which is concerning in and of itself. As a former civil servant, will the Minister tell the House emphatically whether the civil service code was left intact after yesterday’s decision —yes or no?

Chloe Smith: I am a little confused by the hon. Gentleman’s question. I do not know whether he thinks I am a former civil servant, but I am happy to make it clear that I am not. Forgive me, I do not know his biography—[Interruption.] He is a former civil servant; I see. In that case, I am delighted to hear from him given his experience. The only thing I can say is what I have already said—that the person who was providing the briefing was a political appointee, David Frost, and that it is not uncommon for senior civil servants to brief the media on a range of technical issues. The rest of his point goes to questions about codes that are not relevant because of my clarification as to Mr Frost’s status.

Stephen Farry: From the Minister’s previous role in the Northern Ireland Office, she will be aware that a major public inquiry will report shortly, covering—among other things—the role, conduct and behaviour of special advisers. In terms of Whitehall, what can the Minister say to reassure the House that special advisers cannot give directions to civil servants,  and that there is a culture in which civil servants can safely resist inappropriate instructions that they are given by special advisers?

Chloe Smith: I am grateful for that question. As the hon. Member notes, there is much road ahead in Northern Ireland in the restoration of the institutions and the work that goes alongside that. All the codes that buttress our public work—whether for the civil service or special advisers—remain as they were and will be upheld.

Peter Grant: May I advise the Minister that if she is trying to come across as representing a Government who are in favour of freedom of expression and freedom of the press, it is not a particularly good look for each question to be preceded by somebody from the Whips Office scurrying along the green Benches, desperately handing out crib sheets to tell Government Back Benchers what questions to ask and not to ask?
This is the Government who responded to critical coverage on Channel 4 by suggesting that Channel 4 should be closed down, and who responded to critical coverage from the BBC by suggesting scrapping the licence fee—effectively closing down the BBC—so the media have good cause to be concerned. As far as I can tell, the Minister’s excuses are twofold. The first is that it was a specialist briefing; so, presumably the journalists who were thrown out were not clever enough or specialist enough to understand it. The second is that somehow only certain newspaper readers would be interested in what was to be reported. Who decides what the press are interested in reporting? Surely freedom of the press means that the editor decides what the readership are interested in, not the Prime Minister.

Chloe Smith: And that is why we have lobby arrangements whereby every editor—any journalist—with a press pass is more than able to ask any question they like of the Government.

Stephen Flynn: The briefing that took place was on our future relationship with the European Union. My constituency is in Aberdeen, which is projected to be the hardest-hit city in the entire UK as a result of Brexit, yet the Westminster correspondent for the Aberdeen’s local Press and Journal was not invited. Indeed, no Scottish lobbyists were invited to that briefing. Does the contempt that this Government show to Scotland now extend to our press corps too?

Chloe Smith: No, it does not, because we are proudly serving the people of Scotland in ensuring our future prosperity and opportunity through the negotiations on our future relationship that we are conducting with the European Union. I have every hope that the outcome will be as good for the hon. Member’s constituents as it is for my constituents and constituents represented across the Chamber. It is right and proper that it is the United Kingdom Government who do this on behalf of the whole country, and can be held fully to account here in the Chamber and through the very many channels that I have spoken about throughout this urgent question.

Paterson Inquiry

Nadine Dorries: This morning the independent inquiry into the issues raised by the disgraced surgeon, Ian Paterson, published its report. The inquiry was tasked with reviewing the circumstances surrounding the jailed surgeon’s malpractice that affected so many patients in the most appalling way. As the report states, between 1997 and 2011, Paterson saw 6,617 patients, of whom 4,077 underwent a surgical procedure in the independent sector. Between 1998 and 2011, Paterson saw 4,424 patients at the Heart of England NHS Foundation Trust, of whom 1,207 underwent mastectomy.
The report contains a shocking and sobering analysis of the circumstances surrounding Ian Paterson’s malpractice. It sets out the failures in the NHS, the independent sector, and the regulatory and indemnity systems. As a result of these failures, patients suffered unnecessary harm. Their testimony in the report makes harrowing and appalling reading. As such, it is with deep regret that we acknowledge the failure of the entire healthcare system to protect patients from Ian Paterson’s malpractice and to remedy the harms.
Nothing I can say today can lessen the horrendous suffering that patients and their families experienced and continue to go through. I can only start to imagine the sense of violation and betrayal of patients who put their trust in Ian Paterson when they were at their most vulnerable. That the inquiry reports today—World Cancer Day—makes this all the more poignant. I apologise on behalf of the Government and the NHS for what happened, not least that Ian Paterson was able to practise unchecked for so long. I pay tribute to the bravery of all the former patients who came forward to tell their stories to the inquiry, and whose anonymised accounts have been recorded in the report. The report will make for difficult reading, as it highlights the human cost of our failure to detect and put a stop to Ian Paterson’s malpractice.
There was a catalogue of failings that resulted in harm to thousands of patients, causing devastation to countless lives. Some of these patients were let down several times, not least by the providers and the regulatory system that should have protected them, and by the failure of the medical indemnity system to provide any kind of redress at the first time of asking. From the outset, Bishop Graham wanted patients and their families to be central to the inquiry’s work and to be heard. It was right, therefore, that patients and their families saw the report first, early this morning, shortly before it was presented to Parliament.
Two aspects of the report are particularly striking to me: that the various regulatory bodies failed in their main tasks; and the absence of curiosity by those in positions of authority in the healthcare providers in the face of concerns voiced by other healthcare professionals. The report presents a tangled set of processes. Accountability was not exercised when it should have been. Some of the problems arose from not following through on established procedures, as opposed to insufficient procedures being in place.
We must take full responsibility for what happened in the past if we are to provide reassurance to patients about their protection in the future. I am therefore very  grateful that the suite of recommendations, based on the patient journey, presents a route map for Government. The recommendations are extremely sensible and we will study them in detail. I can promise the House a full response in a few months’ time. That response will need to consider the answer to some very important questions that cut right across the healthcare sector. Unequivocally, regardless of where patients are treated and regardless of how their care is funded, all patients should be confident that the care they receive is safe, that it meets the highest standards with appropriate protections, and that they are supported by clinicians to make informed decisions about the most appropriate course of care.
I am very aware that this is not the first time that regulatory failure has been highlighted in an inquiry report. We have done much to make the NHS a safer system in recent years: revalidation, a reformed Care Quality Commission, and work by the Independent Healthcare Providers Network to establish the medical practitioners assurance framework to oversee medical practitioners in the independent acute sector. In the case of Ian Paterson, the system did not work for patients. Recent events at Spire Healthcare show that there are still serious problems to address. Patient safety is a continual process of vigilance and improvement. The inquiry does not jump to a demand for the NHS and the independent sector to invent multiple new processes; it says that they must get the basics right, implement existing processes, and ensure that all professional people behave better and take responsibility.
Last summer, NHS Improvement and I published a new patient safety strategy, led by the national patient safety director, Dr Aidan Fowler. It focused on better culture, systems and regulation—very sensible and familiar words, yet all things that this inquiry says were not delivered. What we need now is action across the NHS and its regulatory bodies, and the same determination to change in the independent sector.
We are absolutely committed to ensuring that lessons are learned and acted on from the findings of this shocking inquiry, in the interests of enhancing patient protection and safety both in the NHS and the independent sector. For today, I apologise again on behalf of the Government and the NHS, and send my heartfelt sympathy to the patients and their families for the suffering they have endured.

Jon Ashworth: I thank the Minister for advance sight of her statement. I welcome her apology on behalf of the Government and the national health service. I agree that the issues raised in this report are, as she says, shocking, serious and harrowing. Our thoughts are naturally with all the innocent victims of Ian Paterson. As the Minister rightly acknowledged, today is indeed World Cancer Day. We all know that a cancer diagnosis is frightening. When we hand ourselves, or a loved one, over to the care of a medical professional, we are literally trusting them with our lives. For that trust to be callously betrayed for financial gain is unforgivable, and indeed, as it has been found, criminal. I associate myself with the Minister’s remarks in paying tribute to all the patients—all the victims—for their bravery in speaking out. I thank all those who have represented them, including the various legal firms such as Thompsons, and thank Bishop Graham for putting together this report.
The findings from the inquiry were published at 12 noon today, so the House will want time to fully digest and reflect on the recommendations. However, I think we all agree that while we cannot undo the awful harm that Paterson’s criminal action has caused to so many, lessons must be learned and changes made so that something so heinous does not happen again. This report must not remain on a shelf to be forgotten, because it is clear that this was not just the action of one rogue lone surgeon; systemic organisational failures were at fault as well.
Fundamentally, it is time that we addressed the question of safety in private healthcare providers and the way in which clinicians are able to operate in private providers with little oversight. Paterson worked under the so-called practising privileges model, effectively as a self-employed contractor whereby people get a fee on top of their NHS salary for each funded NHS operation carried out in the private sector. Moreover, private hospitals would often, and still often, incentivise referrals from consultants by giving them, for example, shares in those private hospitals. This model creates financial incentives to distort clinical decision making and can lead to over-treatment, as we saw in the Paterson case. Indeed, as the Minister said, earlier this month something similar happened at Spire Healthcare when it was forced to recall hundreds of patients amid concerns over operations carried out by another surgeon.
The inquiry makes a number of recommendations and it is right that we reflect on them, but what is clear is that we need full transparency and accountability. I hope the Government mandate health bodies to quickly implement many of these recommendations. The fight that patients had to go through for compensation is, quite frankly, shameful. Surely it is time that private hospitals employed surgeons directly and required them to be fully liable for their actions. In that way, we would resolve the liability loophole.
About a third of all private hospital income now comes from the NHS for hip replacements, hernia procedures, cataract procedures and so on. Yet safety standards in the private sector leave much to be desired. Unlike in an NHS hospital where there are multi-disciplinary teams on standby to deal with potential complications post-op, in the private sector, post-operative care for patients is often left in the hands of a single junior doctor—a resident medical officer often working many hours, 24/7. In private hospitals there are few critical care facilities available if something goes wrong. Indeed, many patients are often referred back to an NHS hospital when complications occur. In 2018, the previous Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), wrote to the private hospital sector telling it to get its house in order on patient safety.
Patient safety must always be a priority. If this demands legislation to change the regulation of private hospitals, I hope the Minister can bring such legislation forward. We would work with her constructively to ensure that it finds its way on to the statute book. It is time to take these issues in the private sector seriously, and we will be happy to work with the Government on that front.

Nadine Dorries: The hon. Gentleman raises many issues that we can agree on. I am not here to defend the private sector, but I would like to reiterate that women were  affected both in the national health service and in the private sector. It does not take into consideration the suffering of those women in the NHS if we just focus on one particular area.
The CQC has had a duty with regard to the private sector since 2015. These cases took place between 1997 and 2011. In 2012, the CQC introduced the revalidation system for doctors, with responsible officers attached to each organisation and an appraisal process that consultants and doctors go through to assess their performance. That happened in 2012 and was introduced by the General Medical Council.
In 2014, we instructed the CQC to appraise the private sector in the same way and hold the private sector to the same standards as the NHS. As I said, I am not here to defend the private sector, but in the CQC examination it came out as good, and I believe that Spire scored 85%.
The hon. Gentleman is right—this is about patient safety and all providers raising their game. As I said, healthcare providers and healthcare professionals have a responsibility to speak out. The time that it took from complaints being made about Paterson to action being taken was too long. We need people in the NHS and the private sector to speak up, to listen and to act more quickly. That is one issue we want to take forward. I will take all his points on board. There is much we agree on. As I said, I am not here to defend the private sector, but women in the NHS suffered as well.

Julian Knight: I thank the Minister and shadow Minister for the tone and content of their comments.
Scores of women and their families in Solihull have been dramatically affected by Paterson, who chose—for want of a better word—to experiment on his patients, seemingly for personal profit, ruining and shortening lives. They want to know that this can never happen again, with proper measures taken and recommendations followed. Does the Minister have confidence in the new whistleblowing procedure at Spire Healthcare? Is she, like me, disquieted to hear that the same hospital is currently reviewing 217 cases regarding another doctor, Habib Rahman, who is under suspension?

Nadine Dorries: My hon. Friend is right; Rahman has been suspended. He is not practising at the Spire group. However, he is still in a non-patient facing role at the trust, and we are querying that.
My hon. Friend is right to say that this has been harrowing, and many women were affected. I do not think I can give him a guarantee that this would never happen again, because for that to happen we would have to have somebody reviewing every single appointment, operation and case that any doctor undertook. We have a process in place now that was not in place then. The CQC was not inspecting the private sector then, and it was not inspecting the NHS robustly enough. That has now changed. We also have the revalidation system, brought in by the General Medical Council in 2012 after Paterson. It is really important to point out that Paterson is in jail and has been for some time. This inquiry came after Paterson had gone to jail, and the purpose of the inquiry is learning, so that we can look  at the recommendations and improve our service to patients in both the NHS and the private sector as a result.

Philippa Whitford: Having been a breast cancer surgeon for 33 years, I find this case heartbreaking, and I can only apologise on behalf of the profession. The hon. Member for Leicester South (Jonathan Ashworth) highlighted that the way in which women were treated after the event and the fact that they had to fight for help and compensation added insult to injury.
As the Minister said, this was not a failure of processes not existing; it was a failure of processes that were not enforced. This scandal went on for 14 years, which highlights a failure to listen to people who raised concerns early on and the fact that there was a power differential between Paterson and people who were raising concerns. It should have been striking that his rate of surgery was so much higher among his private patients than his NHS patients. His practice was not being looked at within NHS quality audits, which might have shown that up. What will the Government do to ensure that all units are taking part in national audits, which faded away over the last decade, and in Getting it Right First Time, so that units cannot just opt out? Will that be rolled out to the independent sector, to ensure that units take part in national audits?
Breast cancer is a multidisciplinary team specialty, but we have to do a 360° appraisal only every five years. To me, that is the most telling and most important part of appraisal, and the Government should look at that part of appraisal being made more frequent and, again, being extended to private hospitals.
The Health Service Safety Investigations Body is currently envisaged as working only in NHS hospitals and for NHS patients treated in independent hospitals. Surely the Government recognise that the Bill legislating for that will need to be amended, to ensure that the HSSIB can investigate across the piece.
Once again, we come back to whistleblowers who have raised concerns, have not been listened to and have been suffering detriment, and an opportunity to stop Paterson many years earlier has been missed. What reforms are the Government planning genuinely to support whistleblowers? I am presenting a private Member’s Bill tomorrow, because we need a root-and-branch reform of how whistleblowers are treated.

Nadine Dorries: The hon. Lady raises a wide range of issues, which I will try to go through. First, I reassure her that, at the time Paterson was practising, the CQC was not investigating or assessing the private sector; that was introduced in 2015. Whistleblowing was in an entirely different place from where it is now. We now have 500 lanyard-wearing national guardians across the NHS, and we encourage people to raise their concerns with those national guardians, the guardians to listen and the trust to act quickly on the concerns raised. I think it is fair to say, that since 2012, when the CQC introduced revalidation, a number of regulatory processes have been put in place. There was shockingly little at the time that Paterson was practising. The system is now much more robust—and yet, I completely take her point; much more still needs to be done.
We are learning the lessons from Getting it Right First Time. In fact, that is a subject of discussion within the Department. We are looking at how the lessons have been applied and what we can learn.
The hon. Lady is right about revalidation and 365° appraisal every five years. As she will know, the CQC is an independent body. It introduced revalidation and appraisal. Our job is now to ask the CQC to make that system more robust and look at how to improve it, because that is an important part of the equation, ensuring that something like this does not happen again. I say here and now at the Dispatch Box that I would like the CQC, as a matter of urgency, to look at how it can make that system more robust and effective, so that we can quickly identify doctors—not those like the hon. Lady—who are not up to standard, who are outliers and who should not be practising.
We will look at the hon. Lady’s point about the HSSIB. I do not think that there is a role for the HSSIB in the private sector. The private sector is a matter of personal choice. It is our job to ensure that healthcare reaches the same standard across the board, whether it is in the private sector or the NHS. The CQC does that, and that is how we hold the private sector to account. Then it is down to patients to make the choice about where they wish to be treated; that is their independent choice. That is a matter of consent, which is something else we need to look at—how do conversations about consent take place? Does the patient have the capacity to take in the information being given to them? Are they making an informed choice? Do they have enough information about the surgeon they are seeing to make the right choice? Those are the issues we need to focus on.

Jeremy Wright: If patients are to be kept safe, several things need to be true. First, as the hon. Member for Central Ayrshire (Dr Whitford) said, medical professionals who have concerns about the practice of other medical professionals need to have their concerns properly listened to. Is it not therefore a matter of serious concern that four of the six whistleblowers in this case—one of whom I have the privilege to represent in this place—found themselves subject to fitness-to-practise reviews after reporting their concerns?
Secondly, is it not right that medical organisations—public or private—need to act on those concerns? It is profoundly troubling that concerns were reported to the Heart of England NHS Foundation Trust in 2003, but it did not suspend Paterson until 2011.
Thirdly, is it not important that regulators do what they need to do? It is also profoundly troubling that concerns about Paterson’s malpractice were reported to the GMC in 2007, and his suspension by the GMC came only in 2012.

Nadine Dorries: I would like to make an apology. I mentioned the CQC in response to the hon. Member for Central Ayrshire (Dr Whitford)—the acronyms!—but it was the GMC.
My right hon. and learned Friend is absolutely right. I reiterate that Paterson is in jail, and that the processes now in the regulatory framework did not exist at the time Paterson was practising. The culture towards whistleblowers is very different now from what it was then, as demonstrated by the roll-out of the national  guardians scheme. The national guardians are there for whistleblowers to go to. We want—we absolutely want—people to report when they think somebody is acting inappropriately, or a surgeon or doctor is not practising to the standards they should be. We want to know that as soon as possible. There will be no investigations of whistleblowers’ fitness to practise; that will apply to the people they are reporting. I do not think the national guardians scheme has had enough press or that people are aware enough of it. It is about speaking up, listening and then the trust acting on the information it has. One of the outcomes of this report will be that we can reassure both healthcare professionals and the public that we want them to speak up. We actually want them to be a whistleblower because only by doing that can we guarantee patient safety.

Diana R. Johnson: I think all of us are shocked to hear that patients have been let down yet again over these events. I was surprised that the Minister did not refer in her opening comments to the Health Service Safety Investigations Bill. I want to back up what the hon. Member for Central Ayrshire (Dr Whitford), who speaks for the SNP, said. Along with her, I was involved in the draft scrutiny of the Bill in the previous Parliament, and it is very clear now that the Bill needs to be extended to include the private or independent sector. I very much hope that the Minister will be able to give us good news about when the Bill will be brought before the House.

Nadine Dorries: I hope the Bill will be brought before the House in the autumn. As I have said, we got the report only this morning, and we need to look at the recommendations. I am sure her suggestion will be one of the recommendations that we will look at in detail. I got the report myself only a couple of hours ago, so we need to study the recommendations. We will report back to the House in three to four months’ time about the report itself.

Saqib Bhatti: Like my hon. Friend the Member for Solihull (Julian Knight), my constituency neighbour, I too have many constituents who suffered at the hands of Ian Paterson. On Saturday, I met survivors of this awful ordeal, and there are no easy words. I thank the Minister and the shadow Secretary of State for their sobering words. Will the Minister join me in commending the survivors for their bravery, and does she agree that there have been serious failings on the part of the Spire hospital? What assurances can we give the survivors that we will take heed of this report, and what more should we do to ensure that this is never allowed to happen again?

Nadine Dorries: I thank my hon. Friend, and if I did not do so in my opening statement I would like to thank the patients, the survivors and the groups that have helped those survivors. I also thank Bishop Graham James, who has provided us with such a thorough and detailed report, with seriously robust and practical recommendations to take forward. Again, I can only give my assurance that we will read this report and study it carefully. If there is anything we can do as a result of the recommendations that will enhance and guarantee patient safety, we will, because patient safety is a paramount concern for us in the Department of Health and Social Care. It is absolutely at the top of our agenda, and we will be taking this forward.

Wendy Chamberlain: In the Minister’s statement, she referred to two striking aspects of the report: the failures of a number of regulatory bodies, and the absence of general interest in the concerns raised by the very people in a position to take action. Sadly, the inquiry suggests that such a case could occur again. Given that the Government have promised to provide a full response to the inquiry in three to four months’ time—I believe that is what she said—how will the Government work with the devolved Administrations to ensure that all health services can take up the same safeguards?

Nadine Dorries: I am sure we will work with the devolved Administrations in the normal way we do with all healthcare policy. Again, I give my assurances that we will be taking the recommendations and studying them seriously.

Jackie Doyle-Price: Ultimately, this is all about behaviour—not just the criminal behaviour of Ian Paterson, but the behaviour of the professionals and the wider health establishment that came into contact with him. I associate myself with the comments of my right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright) about the behaviour towards the whistleblowers. Frankly, they faced intimidation, and we saw exactly the same thing at Gosport when whistleblowers reported to the Nursing & Midwifery Council. I would like to put it on record that it is high time this Government challenged the self-regulatory aspects of both the NMC and the GMC, if we are really to consider and improve patient safety.

Nadine Dorries: I thank my predecessor in my post for her comments. She did an amazing job, and I am sure she will have been involved in this at the time. She is absolutely right: whistleblowers, we want you! We want them to speak up and to speak out; we want people to listen; and we want to act. However, she is also right that there is still a culture among staff within the NHS and the independent sector of reluctance to speak out, to listen and to act, and we need to change that culture. The culture now has to be that we want whistleblowers to speak out, and we want trusts to listen and to take their concerns seriously, because we want to act.

Clive Efford: What has happened is horrific, and my heart goes out to all the people who have been affected, but surely this could not have happened without the collusion of others. It is not just a question of turning a blind eye; there must have been others involved. What has been done to investigate those individuals? Is the Minister clear that whistleblowers have a sufficient pathway to independent investigators outside an organisation? Quite often, it is very difficult within an organisation and it takes someone very brave to go to a senior manager and whistleblow. Is she confident that whistleblowers have access to independent ears to bring their concerns to light?

Nadine Dorries: The national guardians scheme involves 500 healthcare professionals, who are identified by their lanyards alone to show that they are people to whom whistleblowers can speak both independently and in complete confidence. I think that is important because those people are in the NHS—the private sector has rolled out its own similar system—and people can see  them, identify them and act immediately. Sometimes things are left for another time or place, but when people see somebody act inappropriately or in a way they should not, we want to know that they speak out about it immediately.
I will say it again: we want people to speak up, we want trusts and the private sector to listen, and then we want to act. It is the case that we can change this culture and let whistleblowers know that we will protect them. We also have a line at the Department for people to ring in on, because we want to hear from them.[Official Report, 12 February 2020, Vol. 671, c. 10MC.] There is only one way we can guarantee patient safety, and that is to know where inappropriate practice is taking place so that we can stop it. We absolutely open our door to whistle- blowers, and we want to hear what they have to say.

Julian Lewis: Can the Minister explain under what circumstances this criminal behaviour was finally exposed? Has anybody from the regulatory side been sacked as a result of their abject failure to discover it earlier?

Nadine Dorries: There was actually quite a long process. As I say, Paterson practised between 1997 and 2011, and there was quite a long process of reporting and of concerns being raised about his behaviour and his practice. Eventually, somebody listened; I believe that it was a new chief executive at the Spire hospital trust at the time.[Official Report, 12 February 2020, Vol. 671, c. 10MC.] Somebody spoke out to him, he looked at the history of what had happened and he decided to take action. That is not good enough, however, because reports had been made on a number of occasions previously. In fact, there were two reports. One, by a consultant, looked at 100 of his cases in 2011, but no action was taken. Another report, by another NHS consultant, downplayed and focused on the wrong elements of Paterson’s care, and it took somebody to speak to a new chief executive for action to be taken. The process was all wrong, but that is how it was then, and it is very different now.
As I have said, the GMC has introduced revalidation and appraisal. We have been speaking to it, and we want it to make that process more robust so that we can assess doctors in a more appropriate and frequent way. The CQC is holding the private sector to account, as well as the NHS. Those of us who have been here for more than a few years know that a few years ago the CQC was not the organisation that it is today, and it is now much more robust and effective. We therefore hope that we can pick up cases such as this as they happen. However, the only way to crack patient safety in this country is if somebody who is practising alongside a surgeon, doctor or nurse speaks out, and for those to whom they speak to listen, so that we can act.

Thangam Debbonaire: I thank the Minister for her remarks. I welcome her mention of culture and cultural change, but I wish to push her a little further. She spoke about cultural change in relation to whistleblowers, but that is after something has gone wrong. I would like junior clinicians to feel able to challenge senior clinicians before something has gone wrong. Is anything happening to shift the culture, so that a culture of learning is encouraged among senior clinicians, and so that they welcome challenges and questioning from junior clinicians, in order to prevent something such as this from happening?

Nadine Dorries: I am totally with the hon. Lady, and as a nurse myself, I know that that happens with senior nurses, not only senior doctors, because there is the same culture of fear, and of not wanting to challenge a superior who is more experienced in what they are doing. Such a change cannot happen overnight. It will take time, but I think it is already happening as a result of increased confidence. We have recently had a few inquiries, and I think patients now have more confidence to speak out. Under the national guardians scheme, whistleblowers have more confidence to speak out. I think that cultural change is happening, and last week I visited a hospital where I saw that in process.
Our job is to ensure that we introduce whatever needs to be put in place. No one is God. When I trained as a nurse, doctors were like God, but that is not true; that is not the case. This has been a long road, and we need to challenge that culture even further. Those who have been practising for some time are esteemed, and we value their experience. We value those people, but we must also break the culture that means they are not to be challenged. Making the revalidation and appraisal system more robust is one way to do that.

Lucy Allan: I thank the Minister for her heartfelt apology for what has happened, and for her commitment to patient safety. Does she agree that there are clear commonalities between this case and other tragedies, such as those at Morecambe Bay and Shrewsbury and Telford Hospital NHS Trust? As the hon. Member for Central Ayrshire (Dr Whitford) said, there is an imbalance of power between male consultants, and in this case female patients, who often just accept what they are told by a more powerful figure.

Nadine Dorries: This day is about the victims of Paterson and the women he treated, and I do not want to detract from that by going down another road and talking about another inquiry. My hon. Friend is right: often women are those most affected by these issues, which is why I spoke about the importance of consent. We as a Department must consider how such consent is gained, and I think the Cumberlege report, which we are expecting to come to Parliament soon, will help with that.

Mike Wood: No amount of money can repair the suffering of Paterson’s patients and their families, but an inability to pay for treatment or support that might mitigate that suffering can make an already horrific situation even more difficult. Will the Minister look at the adequacy of medical indemnity cover for healthcare professionals, whether they work in the NHS or in the private sector?

Nadine Dorries: The Government are currently undertaking a review of the clinical negligence indemnity cover market, to determine whether wider regulation is an appropriate means of addressing concerns in the market. As part of that they are consulting on the viability of introducing professional or financial regulation, or a combination of both.

Points of Order

Barry Gardiner: On a point of order, Madam Deputy Speaker. Today the Prime Minister is holding an important strategy meeting about COP26—a meeting that many think should have been held before the former President of the COP was appointed, never mind sacked. Have you received any indication from the Government that a statement will be made in the House about perhaps the most important issue facing our country over the next 12 months, which is the climate conference in Glasgow in December? We want to be absolutely bipartisan and ensure that that conference is a success, but we need it to be discussed and debated in this place. The Government must be open with us about the strategy that they want to adopt, so that we can back them and ensure that we achieve the real objectives of the COP.

Rosie Winterton: I thank the hon. Gentleman for giving me notice of his point of order. I am sure that those on the Treasury Bench will have heard his kind offer and his request for a statement to be made, but I have received no notification about a statement.

Neil Gray: On a point of order, Madam Deputy Speaker. I wish to raise a point of order about the Minister’s response to my urgent question on universal credit earlier today, because I believe he may have inadvertently misled the House. I understand that he was defending the Secretary of State from the beleaguered position and shambles that the Department found itself in, which led to the need for the urgent question, and I have informed the Chair and the Minister in question of my intention to raise this point of order.
The Minister first said that he had informed the House about this issue “yesterday”, and went on to say that he had written to the Chair of a yet-to-be-appointed Select Committee in order to do so. Do you believe, Madam Deputy Speaker, that that is informing the House about a major change to our social security system such as this delay to universal credit? My understanding after five years in this House is that properly informing the House is done by a written ministerial statement, or by an oral ministerial statement.
I have since been advised that last night the Minister sent round a “dear colleague” letter, but that is still not informing the House because the Whip’s assistant to whom that letter was sent in our Whips’ Office has been off ill, and I am still to receive a copy. It appears that Ministers sent that letter to people as an afterthought, rather than as a proactive way of informing the House. Do you expect Ministers to inform the House via statements, Madam Deputy Speaker, as I believe has normally been the practice, rather than by letters that can be lost, and do you expect the Minister to clarify the remarks that he earlier put on the record?

Rosie Winterton: I thank the hon. Gentleman for giving me notice of his point of order. He raised a number of issues about what the Minister said and subsequently did, and I am sure that the Minister will want to check the record of what he said in response to the urgent question. Having looked at the record, if the  Minister considers that anything he said was in any way inaccurate, he will want to put the record straight and issue a ministerial correction in the usual way. It is important to be clear about what was actually said and subsequently done.

NHS Funding Bill

Considered in Legislative Grand Committee (England)
[Dame Rosie Winterton in the Chair]

Rosie Winterton: I remind hon. Members that if there is a Division only Members representing constituencies in England may vote.

Clause 1

Funding Settlement for the health service in England

Justin Madders: I beg to move amendment 2,page1,line10,at end insert—
“(1A) The amount spent on mental health services in each financial year set out in the table must be set out in a statement laid before the House of Commons by the Secretary of State no later than 30 June in each year.
(1B) The statement in subsection (1A) must be accompanied by a statement on the Secretary of State’s plans to achieve parity of esteem in mental health services.”
This amendment would require the Secretary of State to report annually on the amount actually spent on mental health services, and on the Secretary of State’s plans to achieve parity of esteem in mental health services.

Rosie Winterton: With this it will be convenient to discuss the following:
Amendment 1, page1,line14,at end insert—
“(2A) For each year in the table in subsection (1), the Secretary of State must specify the amount of the allotment that is for mental health services.”
This amendment requires the Secretary of State to specify the amount to be spent each year on mental health services.
Amendment 5, page1,line14,at end insert—
“(2A) For each year in the table in subsection (1), the Secretary of State must specify the amount of the allotment that is for training for staff to improve maternity safety and care for mothers and babies.”
This amendment would require the Secretary of State to specify the amount to be spent each year on improving maternity safety and care for mothers and babies.
Amendment 3, page1,line18,at end insert—
“and that the sums set out in the table are not permitted to be augmented by or composed of any virements from NHS capital budgets.”
This amendment would stop the Secretary of State meeting the NHS England allotment for resource spending by using funds from NHS capital budgets.
Clauses 1 and 2 stand part.
New clause 1—Annual report on mental health spending—
“The Secretary of State must lay before the House of Commons an annual statement of the outturn of NHS England spending on mental health services no later than six months after the end of each financial year, beginning with the year ending 31 March 2020 and up to and including the year ending 31 March 2024.”
This new clause requires the Secretary of State to report each year on the actual level of spending on mental health services.
New clause 2—Annual Report on Child and Adolescent Mental Health Services spending—
“(1) The Secretary of State must lay before the House of Commons an annual statement of the outturn of NHS England spending on Child and Adolescent Mental Health Service (CAMHS) no later than six months after the end of each financial year, beginning with the year ending 31 March 2020 and up to and including the year ending 31 March 2024.
(2) The annual statement from subsection (1) must report figures on—
(a) CAMHS expenditure per head,
(b) the percentage of the annual NHS England budget allotted to CAMHS, and
(c) the percentage of the annual mental health budget allotted to CAMHS.
(3) The figures in subsection (2) must be broken down by standard regional units in England or by such territories as the Secretary of State considers appropriate.
(4) Each statement under subsection (1) must include an assessment by the Secretary of State on whether expenditure on CAMHS has met the aims of the NHS Long Term Plan.”
This new clause would require the Secretary of State to report each year on the actual level of spending on CAMHS. It requires figures to be broken down by regional units and for the Secretary of State to include an assessment of whether expenditure on CAMHS is meeting the aims of the NHS Long Term Plan.
New clause 3—Allocation of funding—
“The Secretary of State must lay a report before the House of Commons no later than 31 July each year setting out how much in percentage and in cash terms in relation to the amounts set out at section 1(1) has been spent on mental health services in the most recent year ended on 31 March.”
This new clause would require the Secretary of State to report annually on the amount and proportion of NHS England spending devoted to mental health services.
New clause 4—Annual statement on performance—
“The Secretary of State must make a statement to the House of Commons no later than 31 March each year setting out—
(a) whether in the Secretary of State’s opinion the amount specified in section 1(1) for the following financial year is sufficient to meet the performance targets set out in the NHS constitution, and
(b) if in the Secretary of State’s opinion the amount specified in section 1(1) for the following financial year is not sufficient to meet the performance targets set out in the NHS constitution, what steps Secretary of State is taking to ensure that those targets are met.”
This new clause would require the Secretary of State to report annually on whether the allotment to the health service specified in section 1(1) year is sufficient to meet the performance targets set out in the NHS Constitution and, if not, what steps Secretary of State is taking to ensure that those targets are met.
New clause 5—Inflation—
“(1) The Secretary of State must make a statement to the House of Commons in the event that the annual rate of inflation as set out in the Consumer Prices Index is greater than 3.3% in any six months out of twelve after the date on which this Act is passed.
(2) The statement under subsection (1) must specify whether, and by how much, the allotments to the health service in England set out will exceed the amount specified in the table in section 1(1).”
This new clause would require the Secretary of State to make a statement on the impact of inflation above a certain rate on the allotments to NHS England.
New clause 9—Annual parity of esteem report: spending on mental health and mental illness—
“Within six weeks of the end of each financial year specified in the table, the Secretary of State must lay before each House of Parliament a report on the ways in which the allotment made to  NHS England for that financial year contributed to the promotion in England of a comprehensive health service designed to secure improvement—
(a) in the mental health of the people of England, and
(b) in the prevention, diagnosis and treatment of mental illness.”
This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by mental health services that year from the overall annual allotment has contributed to the improvement of mental health and the prevention, diagnosis and treatment of mental illness.
New clause 11—Annual review of adequacy of allotment to NHS England—
“The Secretary of State must lay before each House of Parliament within 14 days of the Treasury laying the annual main estimate for the Department of Health and Social Care an assessment of the extent to which changes in the costs of pharmaceutical treatments, medical devices and service delivery since the date on which this Act is passed have affected the health outcomes in England achieved as a result of the amounts in the table in section 1 of this Act allotted to NHS England.”
This new clause would require the Secretary of State to publish an annual assessment of the impact of changes in the costs of pharmaceutical treatments, medical devices and service delivery on the expected outcomes from the allotted amounts under this Act.

Justin Madders: It is a pleasure to see you in the Chair, Dame Rosie. In my speech I will address amendment 2 and, as we are dealing with everything in one go, the other amendments and new clauses submitted in my name and the names of my right hon. Friends.
It seems that Members across the House are anxious that the Government’s laudable aims on parity of esteem for mental health services are given some legislative teeth. The NHS long-term plan rightly calls for more investment in mental health services to give mental health the same priority as physical health. That is the right approach and it is one that we support. However, as we can see by the amendments that have been tabled today, there is scepticism about how that will actually be delivered. Investment in mental health services has been seriously neglected in recent years and mental health patients are some of the people who have been most let down by the Government in the last decade.
No doubt we will hear from those on the Government Benches that mental health spending is increasing, and that the funding set out in the Bill will benefit mental health services, but the reality is that on this Government’s watch, we have seen a mental health crisis emerge. We are not getting the investment at the level required and services are simply unable to keep pace with demand. As a consequence, the number of people living with serious mental health problems is rising. Patients are unable to access vital psychological therapies within six weeks and often have to wait over 100 days for talking therapy treatments. Thousands of mental health patients continue to be sent hundreds of miles from home, because their local NHS does not have the beds or the staff to provide the care they need. These are often young people in desperate circumstances being sent away from their family and friends—their support network, as it were—and that to me sounds a long way away from parity of esteem. We know that adults in need of help with eating disorders are waiting more than three years for treatment, while hospital admissions for eating disorders increase year on year. The number  of people living with serious mental health problems is continuing to rise and suicide levels are at their highest since 2002.
Even against this awful backdrop, however, it is children’s mental health services that are suffering most from the chronic lack of funding. Children’s mental health services account for just 8% of total mental health spending, and the Government’s continual failure to prioritise children’s mental health has led to services for children effectively being rationed. We know that on average, children and young people visit their GP three times before they get a referral for specialist assessment. They then have to wait more than six months for treatment to start. Suicidal children as young as 12 are having to wait more than two weeks for beds in mental health units to start treatment, despite the obvious risk to their lives.
Three out of four children with mental health conditions do not get the support they need. With over 130,000 referrals to specialist services turned down, despite children showing signs of eating disorders, self-harm or abuse, the problem has become so bad that some children and families are being told by their GPs to pretend that their mental health problem is worse than it is to make sure they get the help they need. Four hundred thousand children and young people with mental health conditions are not receiving any professional help at all—400,000. That is a scandalous figure. We know that mental health conditions in adults often begin in childhood, so it is not only an outrageous dereliction of duty to our young people; it will also end up costing the NHS and society far more in the long run.

Pete Wishart: I do not want to detain the hon. Gentleman too long, because he is making a very good speech and very important points, but I just wonder whether he has any views about the setting of this debate in the Legislative Grand Committee, the de facto English Parliament. SNP Members are excluded from voting in this debate and excluded from tabling any amendments, yet the Bill will have a fundamental impact on the health funding of Scotland through Barnett consequentials. I am interested in his views on that process, so will he say something about them? Can we have Labour support, so that this nonsense stops and we go back to one class of MP in this House where everybody can participate equally?

Justin Madders: I thank the hon. Gentleman for his intervention. I understand his frustration absolutely. I think he has a very fair point, Dame Rosie, that because of the Barnett consequentials there is a role for SNP Members—indeed, all Scottish and Welsh Members—in this debate. Clearly, that is a separate issue to the whole English votes for English laws process, but the fact is clear that on the face of the Bill there are Barnett consequentials, which mean that the devolved nations ought to have a say.
It is really no wonder, given the background I have just set out, that children are reaching a crisis point before getting the support they need, and that the number of children attending accident and emergency for their mental health in a situation of crisis is increasing year on year. That is not inevitable. With real investment, we could reverse the trend of long waits, rationed treatment and inadequate care if we allocated more of  the NHS budget to mental health. As we know, mental health illnesses represent 23% of the total disease burden on the NHS, but just 11% of the NHS England budget. That is a long way off the parity of esteem that we all seek to achieve.
We know that the Government plan to put in an extra £2.3 billion a year by 2023-24, but that is not enough. The Institute for Public Policy Research has said that to achieve parity of esteem for mental health services, funding for those services needs to grow by 5.5% on average not just next year, but over the next decade. The NHS plans to spend £12.2 billion on mental health funding in 2019, but the IPPR estimates that that needs to reach 16.1 billion by 2023-24 alone.
Of course, we support the increased funding for mental health in the Bill, but we know the NHS has to live within the 3.3% uplift provided under the Bill. The Institute for Fiscal Studies, the Health Foundation, NHS providers, the British Medical Association and many of the royal colleges say that health expenditure should rise across the board by 3.4% just to maintain current standards of care. By definition, there will actually be less money for funding in other areas. That means there is a risk of further raids on the mental health budget. In previous years, money allocated to mental health services, particularly children and adolescent mental health services, has been diverted back to hospitals to deal with the crisis there.
Labour would have done what was desperately needed. We would have put in an extra £1.6 billion a year immediately into mental health services, ring-fenced mental health budgets and more than doubled spending on children’s mental health. That is why we are seeking to amend the Bill to ensure mental health services do not lose out because of other financial pressures in the system. We are calling on the Government to ensure that guarantees for mental health funding are protected by ring-fencing mental health funding. We also seek to require the Secretary of State to come to the House annually to report on the amounts and proportion of funding allocated to mental health services, and on their plans to achieve parity of esteem for mental health services.
On the Labour Benches we are not convinced that mental health is a priority for this Government, despite what they say. They may want to position themselves as the party of the NHS, but as long as they continue to neglect mental health and push services deeper into crisis, they will not come near that aim. We intend to push amendment 2 to a Division, because we want to hold the Government to account. We want transparency on mental health spending and we want a clear road map from the Secretary of State on how he intends to make parity of esteem a reality.

Gareth Thomas: I wonder if I could raise with my hon. Friend an example that I think makes his point, which is the state of NHS finances in north-west London, in particular of the acute hospital that serves my constituents, Northwick Park Hospital, and the clinical commissioning group. Both the trust and the CCG are over £30 million in deficit. As a result, they have cut back on community mental health services and, indeed, on a range of other things. Unless there is parity of esteem and unless there is a significantly higher funding boost for the NHS in north-west London than that currently being suggested  by the Conservative party, I fear that mental health services, as he so rightly says, are likely to be cut even further.

Justin Madders: My hon. Friend sets out very clearly the challenge that the Government face from the debt situation in the NHS. Both in-year deficits and total debt to Government have not been addressed adequately or taken into account in the Bill and that is clearly of huge concern.
Amendment 5 deals with patient safety, which should be front and centre in the NHS. When things go wrong, as they sadly do from time to time, it can have tragic consequences for patients and their loved ones. When three in four baby deaths and injuries are preventable with different care, it seems particularly tragic when things go wrong during birth, leaving families devastated by the loss of a child or having to cope with the long-term impact. There have been many things over the years that I have disagreed with the previous Secretary of State—the right hon. Member for South West Surrey (Jeremy Hunt)—about, but on Second Reading he raised the important issue of maternity safety training, calling on the current Health Secretary to reinstate the maternity safety fund. We absolutely agree with him on that, which is why we have tabled amendment 5.
Improved maternal health is one of four priority areas in the long-term plan for care quality and improved outcomes, and it includes action to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by the middle of the decade. As a party, we have pledged to legislate for safe staffing and to increase funding for NHS staff training, including reinstating the maternity training fund to help to improve maternity safety in our hospitals. The leaked interim report of the Ockenden review last year exposed widespread failures in maternity care at Shrewsbury and Telford hospital trusts and demonstrated, sadly, that Morecambe Bay was not a one-off.
An evaluation of maternity safety training from 2016 found that it had made a difference and improved patient safety, yet it was still axed. Just two years later, the “Mind the Gap” report found that fewer than 8% of trusts were providing all training elements and care needs in the “Saving Babies’ Lives” bundle and called for the maternity safety training fund to be immediately reinstated to address, as it said, the
“clear…inadequate funding for training”.
Given the clear evidence of the need for the training fund’s reinstatement, I very much regret that it is not within the scope of the Bill for us to submit an amendment to include its reinstatement. However, with the amendment we seek to put a greater spotlight on the issue, and hopefully, that will require the Government to set out how much they are spending on improving maternity safety and care for mothers and babies each year in order for them to demonstrate their commitment to improving maternity and foetal safety. I believe that that will enable us to judge and evaluate their commitment to those aims.

Alex Cunningham: It is not within the Bill’s scope to press the Government on the need to have funding restored to smoking cessation services so that they can have multimedia campaigns to reduce smoking in pregnancy and smoking generally. Does my hon. Friend agree that it is a shame that the Government cannot address that at this time?

Justin Madders: My hon. Friend is absolutely right: it is a matter of some regret that public health has not been included in the Bill. As we have said repeatedly, we have to look at the health system in the round and include public health and, of course, social care. We cannot deal with those matters in isolation and I believe that it was a mistake for the Government to restrict the Bill in this way.
Despite the many tragedies that we know about in maternity care, it is worth restating that we still have fantastic midwives and fantastic maternity care in this country. That is to be celebrated, but we also need to ensure that when things go wrong—when there are failures and safety issues—we address them and lessons are learned so that no more families have to experience such tragedies.
Amendment 3 is about genuinely giving trusts the certainty that the Bill only purports to do, as well as beginning to tackle the appalling maintenance backlog that has arisen on the Government’s watch. As we know, trusts are around £14 billion in debt to the Government and are currently predicting a £571 million in-year deficit. That is a truly shocking and unsustainable situation. Only short-term fixes have prevented the situation from getting even worse. Such fixes are a symptom of structural long-term underfunding, and like most short-term fixes they create bigger problems further down the road.
We have been absolutely clear that the funding settlement proposed in the Bill is inadequate and that it will not be enough to keep up with demand. As I said, that analysis is shared by just about every major health expert, including the Institute for Fiscal Studies, the Health Foundation, most royal colleges and NHS providers, and the BMA.
In that context, we are concerned that there will be a temptation, as there has been, to dip into capital budgets to paper over the cracks on a day-to-day basis. We have seen that happen five times in the last decade. This means that we now face a maintenance backlog that has spiralled out of all control, topping £6.5 billion. That is an 8% increase on the previous year, when the cost was just under £6 billion. In dollars, that might get us one Steve Austin, but it is not enough to fix the NHS—I suspect that that reference might not mean much to anyone under 40, although I understand that there will be a reboot later this year, so it might become a bit more relevant. However, the point is that this figure has been rising each year for the last six years and it is now 60% higher than it was in 2013-14. It is very clear that the backlog has risen much faster than the resources that have been made available to tackle it.
Over half the backlog represents high and significant risk. That accounts for an increasing proportion of the total backlog figures. High and significant risk represented about 34% of the backlog in 2013-14, but last year—2018-19—it had gone up to 53%. It is getting bigger and all the time, it also becomes riskier.

Gareth Thomas: In support of the case that my hon. Friend is making, I again mention Northwick Park Hospital, which serves my constituents. It has a huge maintenance backlog. Since the cancellation of the Government’s “Shaping a Healthier Future” NHS reform plan for north-west London in June last year—that programme of reform had been going on for seven years  —there has also been no replacement money identified for investment in intensive treatment beds, an extra 30 of which are needed to help to tackle some of the problems in A&E at Northwick Park Hospital.

Justin Madders: My hon. Friend is again showing what an assiduous and determined constituency MP he is. He might want to look at the NHS providers’ report today, which sets out some of the challenges from the lack of a long-term capital investment programme. As we have heard, including from him and in relation to other various examples around the country, this is not just about a lick of paint, but about really vital work that impacts on patient care.

Alex Cunningham: When my hon. Friend talks about capital, I think of the hospital that was cancelled for my constituency by the Tory-Lib Dem Government 10 years ago. Does he share my opinion that when it comes to the capital programme and NHS funding, the Government should consider the life expectancy in different areas? In my constituency, it is 14 years lower than in the Prime Minister’s constituency, so I desperately need a new hospital for my area.

Justin Madders: I am sure that if my hon. Friend continues with his determined campaign, he will see that hospital appear. His point about health inequalities is really important. It is absolutely scandalous that we see such disparity in this country, and we want to see further and more determined action from the Government on that.
Patients ultimately pay for the increasing backlog. Between 2017-18 and 2018-19, there was a 25% increase in clinical service incidents. These incidents are caused by estate and infrastructure failure that leads to clinical services being delayed, cancelled or otherwise interfered with.

Daniel Poulter: The hon. Gentleman is making some very fair points about the importance of investing in hospital infrastructure. A number of years ago, we were promised a paperless NHS, but the reality today is very different. In fact, NHS IT infrastructure is creaking at the seams. There has been a complete failure to invest adequately in that infrastructure, which is compromising patient care. Far too many staff hours are lost on IT systems that are not fit for purpose. Will he join me in urging the Government to take that issue very seriously, because it is about improving patient care as well as improving productivity and better using staff time?

Justin Madders: The hon. Gentleman makes an important point. We have all heard horror stories of workers in the health service having to turn on seven or eight different computer systems and use fax machines and pagers— there were so many fax machines in the NHS I used to think the previous Health Secretary was sponsored by Rank Xerox. It is a serious point though. If we are to improve patient outcomes, we will need to move with the times and get the benefits of technological improvements.

Mark Tami: My hon. Friend will agree on the importance of the Countess of Chester Hospital to his area and mine. It is quite a unique  hospital, in that it was built to serve the people of Deeside in north Wales as well as Chester and the surrounding area, so is it not strange that, although many in my area rely on it, I will not be allowed to vote on the Bill today?

Justin Madders: My hon. Friend makes a pertinent point. Both my parents are residents of north Wales but on occasion use the Countess of Chester Hospital. This process does not take account of the reality on the ground. As I said before, the fact that there will be Barnett consequentials from the Bill suggests that we have made a serious error in not allowing those from the devolved nations to vote on it.
We know what some trusts have told us about the lack of capital investment and what that means on the frontline: Morecambe Bay has said it has “unsuitable” environments for safe clinical care that have led to the closure of its day case theatre; the Queen Elizabeth Hospital in King’s Lynn has warned of a direct risk to life and patient safety from the roof falling in; and at the Royal Derby Hospital, a failing emergency buzzer system in the children’s ward means that staff would be unable to warn colleagues if something went seriously wrong. That is not acceptable.
The capital maintenance backlog will not be addressed unless the Government take note of what NHS Providers says in the report that came out this morning. It talks about the need for the NHS to have a multi-year capital settlement and a commitment from the Government to bringing the NHS capital budget in line with those in comparable economies, which would allow the NHS to pay for essential maintenance work and invest in long-term transformational capital projects of the kind we have touched on. One of our criticisms of the Bill is that capital allocations have not been included in the figures in clause 1, so in order to protect those allocations we have tabled amendment 3, which we hope to push to a vote, to stop the Government’s continual sticking-plaster approach.
I move now to performance targets and our new clause 4. We all know about the record investment and record patient satisfaction levels that the last Labour Government bequeathed to the Conservatives, but another part of their legacy was the NHS constitution, introduced as part of a 10-year plan to provide the highest quality of care and services for patients in England. It included a clear statement of accountability, transparency and responsibility, and standards of care for accessing treatment. These are the figures we often trade across the Dispatch Box.
Only last month, across this very Dispatch Box, the Prime Minister gave us assurances on performance. He said:
“We will get those waiting lists down”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]
We would all like to see that, but we should remind ourselves of the Government’s sorry record: the target for 95% of patients being seen within four hours in A&E has not been met since July 2015; the target for 92% of people on the waiting list to be waiting fewer than 18 weeks for treatment has not been met since February 2016; the target for 1% of patients waiting for more than six weeks for a diagnostic test has not been met since November 2013; and the NHS has not met the 62-day standard for urgent referrals for suspected cancer treatment since December 2015. I fail to see how  the Prime Minister can drive down waiting lists when the level health expenditure he is proposing is not enough to meet existing demand.

Alun Cairns: I note the statistics the hon. Member has shared with the House, but how do they compare to the outcomes that my constituents in Wales face? I would suggest they fare much worse.

Justin Madders: Across the piece, some areas in Wales are actually performing better than areas in England. The direction of travel is the right one. If the right hon. Member is so interested in the performance in Wales, he should stand for the Welsh Assembly; he will have the opportunity to do so in the not-too-distant future. I am sure he was aware when he stood for this place that health was a devolved issue.

Gareth Thomas: I want to raise again the example of Northwick Park Hospital, which serves my constituents. It has not met the four-hour A&E target since August 2015. One of the latest issues responsible for the increasing pressure on waiting times at Northwick Park is the closure of our walk-in services, which were one of the great reforms of the previous Labour Government. Alexandra Avenue, which served my constituency, closed in November 2018, and Belmont health centre, which served the constituency of Harrow East, closed in November 2019. The last walk-in service in the London Borough of Harrow, the Pinn medical centre, which currently is in the constituency of the hon. Member for Ruislip, Northwood and Pinner (David Simmonds), is also due to close, and yet it is increasingly difficult to get an answer to a request for a meeting to discuss that closure with Ministers or the chief executive of NHS England.

Justin Madders: There has to be a correlation between the number of closures my hon. Friend is seeing and his CCG’s debts, which he was referring to earlier. The pressure on frontline services is making these decisions, which it is more and more likely can only impact on performance. I hope that when the Minister responds he will be able to give him the satisfaction of at least a meeting to discuss the issue further.
The funding in the Bill is insufficient to reverse the decline in recent years, let alone deliver the aspirations set out in the long-term plan. It is not just the opinion of Her Majesty’s Opposition that the performance targets cannot be met; NHS England has also made it clear that the core treatment targets cannot be met because of the funding settlement imposed by the Government. And who loses out month after month when performance targets are missed? It is patients. Whether for pre-planned surgery, cancer treatment, diagnostic tests or emergency care, our constituents are waiting longer and longer, often in pain and distress, to access the health services they need. The figures do not lie.
We must remember that the figures are also real people. They are real people stuck on waiting lists: the total number of people on waiting lists in England is now 4.41 million, which is the highest since records began, and up from 4.1 million, when the right hon. Member for West Suffolk first became the Secretary of State. They are real people waiting for treatment: the target to treat 92% of patients within 18 weeks has not  been met for four years—not since February 2016—and obviously has never been met by the current Secretary of State. They are real people waiting for cancer treatment: the Prime Minister himself agreed last month that it was unacceptable that the target for treating cancer patients within 62 days of urgent GP referrals had not been met for five years. That is five years of failure. They are people waiting on hospital trolleys: the number of people waiting four hours or more on hospital trolleys reached 98,452 last December, which is not only a 65% increase on the same point the previous year, but the highest on record.
As we heard on Second Reading, the failure to meet these targets has real consequences. Research from the Royal College of Emergency Medicine shows that almost 5,000 patients have died in the past three years because they spent so long on a trolley waiting for a bed in an overcrowded hospital. As we have said several times during our consideration of the Bill, the true increase in funding is about 4.1%—I will not list again all the bodies that agree with that figure—yet the money in the Bill will not be enough.
This is all before last week’s news about the Chancellor looking for 5% savings in all Departments, including this one. That might not affect the figures in the Bill, but there might be cuts across the wider Department that do have a knock-on impact on service delivery. Let us take a look at A&E. There is increased demand on our A&E services, for many reasons, including the years of cuts to social care, but that is not covered in the Bill. Will the 5% cut come from there—if it does, more and more people will be forced into A&E by a collapsing social care system—or from public health, as we have heard previously, which would inevitably store up problems in the short and longer term?
None of this can be said to be likely to have no impact on performance targets, which for too long have been treated as a poor relation by this Government. The Government have widely ignored them, to the extent that they are spending more time dreaming up ways to get rid of them than to meet them. We say that patients deserve better. We will push the new clause to a vote, because we believe it is clear that the Secretary of State will not be able to drive down waiting lists or drive up performance with the level of health expenditure that he proposes to enshrine in law.
Rather than presenting the Bill as a panacea, let us ensure that the Secretary of State and the Prime Minister are held to account for the promises that they make, and that the Secretary of State comes to this place every year to tell us whether, in the Government’s opinion, the funding allocated for that year will be sufficient to meet those performance targets. If it is not, the Government must set out what they are going to do about it. It is simply not good enough to continue, year after year, to have a Government who treat the targets as an inconvenience. If those standards are to mean anything to patients, and if the Government are serious about persuading us that they mean something to them as well, they will have to come here every single year and tell us, unambiguously and with reference to the funding package for this year, how they intend to meet those targets.
Let me now say a few words about new clause 5 and inflation. I am conscious that a number of other Members wish to speak, so I will be fairly brief. The new clause is  a safeguard to deal with a mistake made in the Bill. Because the amounts are presented in cash rather than real terms, the figures may not end up being as big as they at first appear. While inflation is now relatively stable and within a reasonable range of the Bank of England’s target, I do not think that anybody—particularly at this time—can confidently predict the rate at which it will be running at in two, three or four years’ time.

Philippa Whitford: Is that not the most critical weakness in the Bill? Given that inflation is expected to rise after Brexit, the figures for 2023-24 are just guesswork. There should be a commitment to £20 billion by that year, in real terms.

Justin Madders: There are indeed many weaknesses in the Bill, which, given that it is so short, is quite an achievement on the Government’s part. That is the point of the new clause. We cannot say with any certainty what the rate of inflation will be in a few years’ time. It is important for funding that is seen as adequate now—at least by Conservative Members, if by no one else—not to be downgraded further as a result of economic turbulence. We have had no guarantees that a different economic picture will change the Government’s stance. Indeed, when on Second Reading we sought assurances that the NHS would still receive the real-terms increases envisaged in the Bill should inflation run at unforeseen levels in the future, no commitments were forthcoming. When pressed by my hon. Friend the Member for Nottingham South (Lilian Greenwood), the Secretary of State could not give the cast-iron commitments that are needed by those delivering the services. Even if this is an unsatisfactory settlement, they deserve some certainty that the sums involved will not be eroded by spikes in inflation.
As the Secretary of State said on Second Reading,
“The crucial thing in this Bill is the certainty.”—[Official Report, 27 January 2020; Vol. 670, c. 560.]
We are not sure whether he meant certain failure, because we know that the sums set out in the Bill are not enough to keep up with demand, but the new clause seeks to ensure that the NHS is, at least to some extent, insulated against unforeseen economic shocks. It would act as a safety net in the event that inflation ran above 3.3% for more than six months in any 12-month period. It also requires a statement from the Secretary of State about whether any additional funds will be made available to supplement the sums set out in the Bill. That would at least provide some clarity and certainty about whether there will be any real-terms reduction in funding as a result of a sustained rise in inflation.
Let me finally say a little about new clause 11, and the adequacy of the allotment to NHS England. As I have already made clear, the Bill sets NHS expenditure for the next four years at a level that is not sufficient to put the NHS on a sustainable footing or to improve performance. That is why we are seeking to ensure that the impact of unforeseen changes in the costs of pharmaceutical treatments, medical devices and services—possibly as a result of our leaving the European Union, or of the trade deals that we sign—are reviewed by the Government so that adequate funds are available to meet any uplift, and so that there is no negative impact on health outcomes. Much has been said about the possibilities in new trading arrangements, but not enough about the risks, of which this is only one.

Jeremy Hunt: It is a great pleasure to follow the hon. Member for Ellesmere Port and Neston (Justin Madders). We were on opposite Front Benches for many years, but I always had great respect for his detailed understanding of healthcare issues and the integrity of his approach. He once wrote me a private letter. I will not divulge its contents; suffice it to say that it demonstrated his recognition that we are human beings on this side of the House. That was a rare admission from a member of the Labour party, and I am very grateful to him for it.
I will not be supporting the hon. Gentleman’s amendments and new clauses, but I think he is right to raise the issues that he has raised, and I want to propose some different ways of achieving his objectives. I am very pleased that he has raised the issue of mental health and mental health funding, and I therefore wish to speak to amendments 1 and 2 and new clauses 1, 2 and 3.
I think that all hon Members have knocked on the doors of constituents—I did as Health Secretary—and been confronted by people who have been given a totally inadequate service in relation to their mental health or that of their children. One person I met, who was not a constituent, was a very remarkable gentleman called Steve Mallen. He had a son, Edward, who had an extraordinarily promising life in front of him. Edward had secured a place at Cambridge, he was very musical, he had friends; and then, in the year before he was due to go up to Cambridge, he had a six-month period of severe mental illness and ended up killing himself, five years ago this Sunday. I think that all of us have to have people like Edward Mallen at the back of our minds, and to remember, as we enjoy a normal weekend, that for Edward’s family Sunday will be a very, very challenging day.
I believe we could all come up with stories like that. I mentioned Steve Mallen because he has chosen to relive the grief that he feels for his son Edward. He made a promise at Edward’s funeral that he would campaign to ensure that other people received the mental health provision that Edward did not receive. He subsequently set up the Zero Suicide Alliance with an inspirational NHS chief executive called Jo Rafferty, who runs Mersey Care. It is a fantastic project, and I am pleased to say that the Health Secretary has agreed to a meeting to discuss continued funds for the alliance. As we think about people like Edward, it is important to understand just why funding for mental health has not increased at the rate at which it should have, and why we do not have the service provision that we should have.

Stephanie Peacock: Does the right hon. Gentleman share my concern about the fact that the mental health charity Combat Stress has said it is unable to accept any more new cases? Support for the charity, which helps military veterans, has fallen in the last few years, and 90% of its income consists of public donations.

Jeremy Hunt: I am well aware of the fantastic work done by Combat Stress, and I think it is important for it to receive the funds that it needs. However, when we look at the root cause of the problems in mental health funding, we see that on both sides of the Committee there is some culpability, and that on both sides it was completely unintentional. I hope that the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), will forgive me if I start with the other side.
The truth is that when targets were introduced in the 2000s for A&E and elective care waiting times they were hugely effective, but they were introduced only for physical healthcare. As a result, during the austerity period when the budgets of clinical commissioning groups or primary care trusts were under pressure, money was sucked out of community and mental health services. That is at the heart of the problem that has bedevilled mental health care. The position changed in 2012, because a Labour amendment to the Bill that became the Health and Social Care Act 2012 instituted parity of esteem between mental and physical health. We were the first country in the world to do that.
As a Conservative, I am always deeply sceptical about legislating for principles, because I am not totally convinced that it ever changes anything, but that amendment did bring about a significant and very practical change, which I discovered myself as Health Secretary. No Health Secretary and no NHS chief executive ever wants to have to say publicly that the proportion of funding going to mental health has fallen on his or her watch, because that would be a direct contradiction of the principle of parity of esteem. That is why, since this became law, we have seen the proportion of funding of the entire NHS budget going into mental health either stabilised or starting to go up. That should put to rest some of the Opposition’s concerns about the risk of a decreasing proportion of NHS funding going into mental health, but it does not solve the problem.
The issue when it comes to mental health services for our constituencies is not about political will or funding; it is about capacity. We have an enormous number of ambitious plans on mental health. I unveiled one—in 2016, from memory—that said we would treat 1 million more people by 2020 and increase spending by several billion pounds. The mental health “Forward View” had some very ambitious plans, and we had the children and young people’s Green Paper. There are also targets to increase access to talking therapies, which are essential for people with anxiety and depression. But if we do not increase the capacity of the system to deliver these services, in the end we will miss the targets. For example, the children and young people’s Green Paper is an incredibly important programme, with a plan for every secondary school in the country to have a mental health lead among the teaching staff who would have some of the basic training that a GP would have to spot a mild mental health illness, anxiety or depression, or a severe one such as OCD or bipolar, and therefore know to refer it—[Interruption.] I am getting a look. I understand, and I will draw my comments to a close—

Steve Double: No, you are meant to face the Chair.

Jeremy Hunt: Thank you. I am sorry—I am new to this Back-Bench stuff. Apologies for not facing the Chair. I will now do so more diligently.
The point I wanted to make, Dame Rosie, is simply that the children and young people’s Green Paper requires an increase in the children and young people’s work- force of—from my memory as Health Secretary—9,000 additional people. The CAMHS workforce is actually only 10,000, so the Green Paper alone requires a near doubling of the mental health workforce. Far be it from me to teach experienced Opposition Members how to scrutinise the Government or hold them to account, but  if they really want to know whether we are going to deliver on those promises, looking at the workforce numbers in children and young people’s mental health in the CAMHS workforce is the way to understand whether we are going to be able to deliver those extra commitments.

Mark Tami: Is not that the key point? Young people’s experience of CAMHS on the ground is that they just cannot get an appointment. Rather than being seen in the early stages, as they should be, they often get seen only when they have become suicidal or have tried to commit suicide. That is the wrong way round.

Jeremy Hunt: The hon Gentleman is absolutely right. On both sides of the Chamber, we are totally committed to the NHS and totally committed to transforming mental health services, but I am afraid that young people are regularly turned away from CAMHS and told, “You are not ill enough yet. Come back when things get worse.” Why is that such a tragedy? Because half of all mental health conditions become established before the age of 14, and the way to reduce the pressure on the NHS is to intervene early. That is what does not happen.

David Simmonds: In support of what my right hon. Friend has said, I think that one of this Government’s great initiatives in respect of children’s mental health in the past decade has been the work done through the health and wellbeing boards. I know that this was strongly supported by him when he was Secretary of State and by other Ministers since. Every local authority, using its connections with the schools and general practitioners in its local area, has a plan that reflects local need. This has evolved over the years to change the commissioning priorities at local level, which is reflected in what is purchased from NHS providers to address local need. I offer as an example an online counselling service that has been introduced to serve my constituents. The feedback from young people is that it is tremendously more accessible than what was there previously, and it is a lot less expensive than the type of services previously being commissioned. That demonstrates the commitment we have on the Government Benches to addressing children’s mental health.

Jeremy Hunt: My hon. Friend has huge experience of this in local government, and he is absolutely right. The big surprise for me when we were conceiving of the children and young people’s Green Paper was the willingness of NHS professionals to accept that the people who know the kids best are their teachers, rather than GPs, because the teachers see them every day and are probably going to be better at spotting a mental illness and being able to do something about it.

Barbara Keeley: I would like the right hon. Gentleman to consider whether he supports an important proposal that we put forward at the general election. It was that there should be a trained counsellor in every school to spot mental health problems. Putting that burden on to teachers and others in the teaching profession is the wrong way forward. In Wales, we have the experience that having trained counsellors in schools relieves the pressure on CAMHS. If we want to take children’s mental health seriously  and relieve the pressure on CAMHS, we should do this. I have a couple of schools in my constituency that have trained counsellors, and it really helps. The other thing that we proposed was to have a mental health hub in every local authority area, so that children and their families in crisis would have somewhere to go where there would be professionals and charities that work in mental health. Those ideas that we put forward really should be considered, and I wonder whether the right hon. Gentleman supports them.

Jeremy Hunt: They are both interesting ideas. The plan at the moment is that resource will be given to schools for a teacher to volunteer to devote a proportion of their time to this, and that there will be funding for them to do so, similar to the way in which schools have a special educational needs co-ordinator who is a teacher devoted to the special needs of the pupils in that school. I personally would have no objection if that were a separate counsellor, but this needs to be a resource inside the school—someone who is regularly at the school and who knows the children there. That is the important thing.
With permission, Dame Rosie, I would like to comment on some of the other amendments and on some of the comments made by the hon. Member for Ellesmere Port and Neston. He rightly talked about the issues around maternity safety, and I agree that it is vital that we continue the maternity safety training fund. That is not directly the subject of one of his amendments, but it is indirectly connected to it. Twice a week in the NHS, the Health Secretary has to sign off a multi-million pound settlement to a family whose child has been disabled for life as a result of medical negligence. What is even more depressing is that there is no discernible evidence that that number is going down. The reason for that is that when such tragedies happen, instead of doing the most important thing, which is learning the lesson of what went wrong and ensuring that it is spread throughout the whole country, we end up with a six-year legal case. It is impossible for a family with a child disabled at birth to get compensation from the NHS unless they prove in court that the doctor was negligent. Obviously, the doctor will fight that. That is why we still have too much of a cover-up culture, despite the best intentions of doctors and nurses. This is the last thing they want to do, but the system ends up putting them under pressure to do it. That is why we are not learning from mistakes. I am afraid that that is the same thing that was referred to in the Paterson inquiry report that was published today: the systemic covering up of problems that allowed Mr Paterson’s work to carry on undetected for so long. The hon. Member for Ellesmere Port and Neston is absolutely right on that.
I think it is a fair assessment of safety in the NHS to say that huge strides have been made in the past five or six years on transparency. It is much more open about things that go wrong than it used to be, and that is a very positive development. But transparency alone is not enough. We have to change the practice of doctors and nurses on the ground, and that means spreading best practice. Unfortunately, that is not happening, which is why, even after the tragedies of Mid Staffs, Morecambe Bay and Southern Health, we are facing yet another tragedy at Shrewsbury and Telford—I see  my hon. Friend the Member for Telford (Lucy Allan) in her place, and she has campaigned actively on that issue. The big challenge now is to think about ways to change our blame culture into a learning culture.

Jerome Mayhew: I declare an interest in that, a long time ago, I was a personal injury barrister, including in cases of medical negligence. Does my right hon. Friend think a possible solution to the resistance to blame in the national health service might be the adoption of a no-fault compensation scheme much like that in the personal injury sphere in New Zealand, for example?

Jeremy Hunt: My hon. Friend makes an important suggestion. We considered such a thing when I was at the Department of Health and Social Care, but we decided that it would be very expensive. One of the tragedies is that many people who suffer actually make no legal claim because they are so committed to the NHS, so we have a system that gives huge amounts of money to one group of people and nothing at all to those who decide that they do not want to sue the NHS.
We need to look at tort reform, because most barristers and lawyers working in this field want the outcome of their cases to be that the NHS learns from what went wrong and does not repeat it. Unfortunately, that is not what happens with the current system. The involvement of lawyers and litigation causes a defensive culture to emerge, and we actually do the opposite. We do not learn from mistakes, and that is what we now have to grip and change.
I want to say something positive, because if we do change that we will be the first healthcare system in the world to do it properly. We are already by far the most transparent system in the world, mainly because people in this place are always asking questions about the NHS—and rightly so. Healthcare systems all over the world experience the same problem. It is difficult to talk openly about mistakes because one can make a mistake in any other walk of life and get on with one’s life, but if someone dies because of the mistake, that is an incredibly difficult thing for the individuals concerned to come to terms with. That is why we end up on this in this vicious legal circle.
On capital to revenue transfers, I was a guilty party during my time as Health Secretary. There were many capital to revenue transfers because we were running out of money, so capital budgets were raided. I fully understand why the Opposition wanted to table amendment 3, but I respectfully suggest that the trouble is that it would result not in more money going into the NHS but in more money going back to the Treasury from unspent capital amounts. The real issue of capital projects is getting through the bureaucratic processes that mean that capital budgets are actually spent.

Pete Wishart: I congratulate the right hon. Gentleman on securing the chairmanship of the Health and Social Care Committee, and I look forward to joining him on the Liaison Committee. He is a former Secretary of State, so he surely understands and appreciates that this Bill has a significant impact on Scotland, because it will affect our budgets through the Barnett consequentials. Does he think it is right that we are excluded from tabling or even voting on any amendments?

Jeremy Hunt: I do, because this Bill about the NHS in England. It would be nice if we occasionally had a word of thanks, because the Bill will result in a lot more money being made available for the NHS in Scotland. The hon. Gentleman should, if I may say so, welcome that, because I think that will be as welcomed among the Scots as it will be welcomed by the English.
My point about capital to revenue transfers is that it is a big deal to get a hospital building project off the ground. So many get delayed because hospital management teams are very busy. They may have struggling A&E departments and are trying to meet other targets and to deal with safety issues—whatever it is—and they do not have the management resource to invest in putting together the case that, quite rightly, the Treasury and the Department of Health and Social Care demand is extremely rigorous and thorough. That is why things get delayed. If we want to ensure that these 40 hospitals get built, the Government should consider a central team at the Department of Health and Social Care to put at the disposal of hospitals that we want to build extensions or new buildings, so that they can actually navigate those hurdles—[Interruption.] I am getting nods from the very capable Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), so that might be under consideration.

Alex Cunningham: I am grateful to the former Secretary of State for giving way. I admire his admitting his role in converting capital to revenue, and I am sure he regrets that he was unable to build the hospital we need in Stockton to close the health inequality gaps in our society. If he has any influence left in Government, perhaps he will have a word in some ears and say, “They really do need a new hospital in Stockton-on-Tees.”

Jeremy Hunt: I can be honest with the hon. Gentleman and say that I regret not being able to build lots of hospitals around the country in that period, because funding was short. Now, however, we are in a different situation. It is important that we build these extra hospitals, but there will be some big challenges in ensuring that we do so.

Philippa Whitford: I thank the right hon. Gentleman for giving way. I welcome his suggestion of a central design team, because the NHS is over 70 years old and we seem repeatedly to reinvent the wheel. Does he recognise that it is not just about building new hospitals, because maintenance has also been allowed to slide? There are leaking roofs and leaking sewers, and patients are still in hospitals that are basically not fit for use. Maintenance is most urgent.

Jeremy Hunt: I agree with the hon. Lady. Maintenance is a big issue in many hospitals. A number of hospitals are still essentially prefab buildings that should have been torn down a long time ago, and there are others where maintenance can solve the problem. I think we have to attack all of that, and I welcome the fact that there is a real commitment from the Government to do so.
Finally, I want to talk about new clause 4, which relates to whether the Government are giving enough to the NHS to meet the current waiting time targets for elective care, A&E, cancer and so on. I welcome the Opposition’s focus on this matter, because the public  absolutely expect us to get back to meeting those targets. It was an important step forward for the NHS that we did bring down waiting times, and I have often credited the previous Labour Government for that happening, as I hope the Labour party will credit this Government for the focus on safety and quality in the wake of Mid Staffs. However, as we focus on safety and quality, I would not want to lose the achievements that were made on waiting times, because it is fundamental to all patients that they do not have to wait too long for care. Indeed, waiting times themselves can be a matter of patient safety.

David Simmonds: My right hon. Friend mentioned targets and people getting access to care. The hon. Member for Harrow West (Gareth Thomas) referenced Pinn Medical Centre, which is in my constituency, and the impact on Northwick Park Hospital in his constituency. This is a really good example of when the issue is not with the total sum of funding but with how the NHS is spending it. If the system can afford £300 to pay for each A&E attendance, I am sure it can afford £70 for those patients to attend a walk-in centre instead. This is not about an arms race and who can spend the most, but about who can bring the most focus to spending the money in the way that benefits patients and our constituents the greatest.

Jeremy Hunt: My hon. Friend neatly makes the point that I was hoping to make next. I will elaborate on the brilliance of his insight and simply say that when we think about waiting times it is very important that it is not just a debate about money. I appreciate that the Bill is about money, and that is why amendments have been tabled about money, but I want to give the example of the annual cycle of winter crises that we seem to have in the NHS now. I looked up the figures and, over the past five years that I was doing the job, in the first year I gave the NHS £300 million to avoid a winter crisis; in the second year, £400 million; in the third year, £700 million; in the fourth year, £400 million; and in the fifth year, £400 million. In four of those five years, we still had a winter crisis. That is because in the end it is not about money as much as it is about capacity.
If we do not have the additional doctors and nurses available to provide the care that we want to be provided, money will disappear very quickly and we will not see any benefit for it. If we want to get back to those waiting time standards—and no one would want to do that more than I do—we have to look at the issue of capacity, and in two areas in particular.
First, are we actually training enough additional doctors and nurses? I introduced some big increases—a 25% increase in doctors being trained—and of course because it takes seven years to train a doctor, they will not start to come through until towards the end of this Parliament. The Government have announced a big increase in the number of nurses that they want to recruit, but training new nurses takes three years. Looking at whether those numbers are right will be absolutely essential if we are to break the cycle of winter crises. Essential to that is to ensure that we have an independent estimate of the number of doctors, nurses, physiotherapists and allied health professionals that the NHS actually needs and a Government who sign up to training those numbers.
If that number is the result of a negotiation between the Treasury and DHSC, the Treasury will negotiate those numbers down because it always sees training more doctors and nurses as building up a cost pressure for the future. Actually, it is the opposite: if we do not train enough doctors and nurses, the NHS ends up having to pay extortionate agency rates and locum doctor rates, and it ends up costing the NHS more. I would like an answer to the question of whether we are even now training enough doctors and nurses, and I would like to know what the NHS actually believes is the answer to that question. I would also like to know that the Government are committed to doing that, and I very much hope that when we have the people plan, there will be an independently audited projection of the number of doctors and nurses required.
The final point I wanted to make is about—

Patrick Grady: The third final point.

Jeremy Hunt: It was always the final point, and it is very much the final point.
The other area that is essential for capacity is the social care system. My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) talked about how money can be wasted. One of the biggest wastes of money is that we pay for people to be in hospital beds, which cost three times as much as care home beds, because we do not have the capacity in the social care system. It is very important that we encourage people to save for the future and protect people against losing their homes, but if we want to see a change in the NHS in the next five years it is fundamental that we increase the ability of local authorities to deliver adult social care to people who cannot afford it. At the moment, they do not have enough to do that, and we must put that right.

Patrick Grady: Finally, here we are, in the English Parliament after all these years. Isn’t it great? The Mace is down, the signs are up, and the dream of David Cameron has finally been realised. For the first time since 1707, English Members of Parliament will get to vote on English legislation to the active exclusion of the rest of us. I wonder if the Minister could have even dreamed, when he and I were but lowly Back-Bench members of the Procedure Committee back in 2015 and scrutinising the EVEL processes, that this is where we would end up today.
On 19 September 2014 David Cameron promised, in response to the independence referendum in Scotland, that we would have English votes for English laws. Three general elections, two Prime Ministers and countless Leaders of the House later, here it is in all its glory. I wonder, given the responses and speeches that we have heard today, whether anyone on the Government Benches really understands what is going on. We are debating clauses and amendments to a Bill that has been certified as being only relevant to England, but as the amendment themselves demonstrate, and as we have heard in speeches, it will have implications for health spending policy across the whole of the United Kingdom—and very serious issues, too—for mental health, for the construction of hospitals, and for the difference between capital and revenue spending on the NHS.

Pete Wishart: I wonder whether, like me, my hon. Friend feels that this English Parliament is actually pretty similar to the usual Westminster Parliament that we do all our business in. Does he agree that the English votes for English laws procedure has been about the most divisive, disruptive and useless procedure ever put into this House? It makes distinctions between classes of Members of Parliament in this House, and what we are doing today is disallowing us to vote on issues that are vital to the Scottish health service. Does he agree that it is a disgrace, and that it must go?

Patrick Grady: Yes; I absolutely agree. My hon. Friend is right: I barely noticed the difference as this place magically transformed itself into the Legislative Grand Committee (England). Incidentally, I do not know whether he remembers, from his time here, whether the Scottish Grand Committee was ever permitted to meet in the Chamber of the House of Commons. I fear it was not, so quite why the English Grand Committee enjoys that privilege and does not have to meet elsewhere in the building or elsewhere in England is kind of beyond me. But my hon. Friend is right that those of us from seats in Scotland and Wales and Northern Ireland are, for the first time, being actively excluded from the opportunity to vote on amendments.
The right hon. Member for Alyn and Deeside (Mark Tami) may also have been a member of the Procedure Committee back in the day; I certainly seem to remember points about the cross-border hospitals being raised. He has constituents in Wales who use hospitals in England that will be affected by this legislation, and he is unable to vote on or amend those provisions.

Neil Gray: My hon. Friend’s secondment to the English Parliament is going rather well so far, although it is rather similar to the UK one. Does it not distil the ridiculousness of the EVEL procedure that we have before us a Bill that clearly impacts on the funding of the NHS in Scotland, as the former Secretary of State mentioned, and yet the Government have put the Chair in the invidious position of deciding on the issues that we can or cannot vote on, instead of our making that decision about the issues that are important to our constituents?

Patrick Grady: My hon. Friend is absolutely right; and we raised those points five years ago, when the EVEL process was being introduced.

Mark Tami: I have never been a member of the Procedure Committee. The Countess of Chester, which is a foundation hospital, has trustees who are elected from Wales. They are elected and can take part in decision making, but as an elected representative in this place, I cannot, apparently.

Patrick Grady: There we go. We have now had as many Welsh and Scottish Members contributing from the Floor, as Members from elsewhere in the United Kingdom. These points were raised back in the day, on the Procedure Committee, even if it was not the hon. Gentleman who gave that evidence.
This morning, the Prime Minister turned up at the Science Museum in London to launch a conference that is taking place in Glasgow. That probably tells us all we  need to know about the Government’s concept of how the United Kingdom works. Four days after the UK leaves the European Union, and the Tory Government choose to display their love for the precious Union on these islands by creating two classes of Member in the House of Commons—those who can amend legislation and those who cannot. Well, as the Chair of the Health Committee asked us to say, “Thank you.” Thank you so much, because the polls are showing that support for independence in Scotland has reached 52% and growing, and that support will not go away. Constituents in Scotland will be watching today’s proceedings, wanting to know why their Members of Parliament are not allowed to vote on amendments that could increase health spending, not just here in England but throughout the United Kingdom.
Labour’s new clause 5 rightly calls for the Government to analyse the effect of inflation on the figures set out in the Bill.

Philippa Whitford: Does my hon. Friend agree that, as I mentioned earlier, the fact that inflation could make these cash rises meaningless makes it very difficult for the Scottish Government to predict what Barnett consequentials they can count on in 2023 and 2024, so it should be committed to in real terms, not just cash terms?

Patrick Grady: Yes; my hon. Friend is absolutely right, and we would be very happy to support new clause 5 if the procedures of the House allowed us to. It is absolutely crucial to what the Bill is trying to achieve.
We know it is a showpiece Bill anyway, but the Government are getting a showpiece English Parliament out of it as well. Of course, the terms of the money resolution are so restrictive that amendments intended to amend the figures in the Bill are completely out of order. The Labour party tried that—that point was raised by more than one Opposition Member at Second Reading, and I am not sure that Ministers could answer it.
Labour’s amendment 3 prevents capital funding from being transferred to revenue streams. That is hugely important as well, because any increases in the revenue funding—the figures on the face of the Bill—have to come from new money. Otherwise, the whole thing is pointless: it is just shuffling things around. It is new money that would give rise to Barnett consequentials, and that is where our interest comes in.
New clause 4, on performance targets, makes exactly the same point, and we support that as well. That is also relevant to us.

Philippa Whitford: It is often cast up here that the Government in Scotland are not spending all the Barnett consequentials on health, but they do. The problem is that although the Government here keep talking about the rise they are giving to the NHS, there are cuts to public health and social care, and there have been cuts to education and training. In Scotland, we still take the whole responsibility of a health Department seriously.

Patrick Grady: My hon. Friend is absolutely right on that. The Scottish National party has always pledged—we have done this throughout our time in government—that any Barnett consequentials that arise from health spending in England get passed to the NHS in Scotland. Any time the figures set out in this Bill increase, those  Barnett consequentials would be expected to fall to the Scottish block grant, so it is well within the interests of Members from Scotland, Wales and Northern Ireland to seek to amend this Bill. Our own unselectable suggestions that appear on the amendment paper require analysis of what would happen if health spending per capita in England and Wales was raised to the level in Scotland. That was part of our manifesto commitment; by raising health spending in England, we would also raise spending across the United Kingdom. But here and now, on the Floor of the House of Commons, in the UK Parliament, that idea cannot be tested, voted on or even, technically, discussed.

Philippa Whitford: Does my hon. Friend agree that “per capita” is a much more informative way of describing spending, because demand is increasingly rapidly, with an ageing population that is not ageing healthily, and just talking about the headline numbers does not show whether the amount provided for each person is sufficient to provide their services?

Patrick Grady: I thank my hon. Friend for that. The contributions she is making demonstrate precisely why Members from Scotland should have been allowed to participate fully in this stage of the Bill and the whole process.
If the official Opposition choose to press any of their amendments this afternoon, we will seek to express our views, on behalf of our constituents, by walking through the Lobby. We will walk past the signs that say, “England only” and if the Tellers from the Government Whips team choose not to count us, that will be their decision. Of course they will also have to discount any of their own colleagues from Scotland and Wales who deliberately or accidentally end up in the Lobby; perhaps that is also an argument for getting rid of this ridiculous voting Lobby system, but I appreciate that that is for another day.
The Government could have avoided this situation, by allowing proper time for a Report stage, where Members from Scotland and elsewhere could move amendments. They could have committed the Bill upstairs to a Public Bill Committee, but they chose to convene an English Parliament here in the Chamber of the House of Commons, which is supposed to represent the whole of the UK.

Pete Wishart: My hon. Friend has taken over the EVEL mantle with great aplomb. I understand that the “England only” signs are already in the Lobby, and this in the UK Parliament of Great Britain and Northern Ireland! What does that say to people from Scotland? What does it say, given that this Bill determines so much of our health spending in Scotland? Surely the days of EVEL have to come to an end. We cannot go on like this. This is the Parliament for everybody across the United Kingdom; it is not their Parliament to squat in.

Patrick Grady: It really does not feel like that at the moment, does it? Hear no EVEL, see no EVEL, speak no EVEL should be the mantra, because my hon. Friend is right; this might not be the last time.

Drew Hendry: I am grateful to my hon. Friend for allowing me to speak in the English Parliament for the  first time. Does he agree that one way to get around this whole EVEL conundrum is simply for the English Parliament to be made officially an English Parliament and then we can all have our own national Parliaments in our own countries?

Rosie Winterton: Order. I am sure colleagues will appreciate that it is important that we actually talk about the Bill.

Patrick Grady: I wholeheartedly agree, Dame Rosie. I have addressed the amendments that we have an interest in, and I am contextualising why they are relevant to our constituents, but points are being extremely well made by my colleagues. There is a simple solution to this, which we in the SNP have been promoting for 84 years, since 1934: Scotland can become an independent country and England can have the Parliament that it wants. As my hon. Friend the Member for Airdrie and Shotts (Neil Gray) says, with the greatest respect for the Speaker, it should not be for the Chair or for the Government to decide what does and does not apply to Members from different parts of the UK. My job and that of my colleagues is to look at each measure before this House and determine for ourselves whether it is relevant to our constituents and act accordingly. Today, we are being actively prevented from doing that. There are amendments and new clauses on the amendment paper that we deem to be of interest to people in Scotland, which would take forward commitments in our manifesto, but we will not be able to vote for them. That is not a precious Union. That is not a partnership of equals. That is not leading instead of leaving. It is not something that is going to be sustainable for much longer, and 52% of people in Scotland seem inclined to agree.

Anne Marie Morris: I rise to speak to new clause 9, tabled in my name and those of the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Broxbourne (Sir Charles Walker). I am pleased that Scotland will have its say, at least with regard to this new clause.
Conceptually, the Bill will absolutely do the right thing, because for long-term decision making we need some clarity as to how much money there will be. As I said on Second Reading, my concern is about whether or not the figures are right, and at that point I proposed a formula that would enable the figures to be flexed to properly determine the need and whether the figure would to be sufficient to meet it.
New clause 9 deals specifically with the issue of mental health. There is agreement among all parties that it is crucial that we get mental health right. It is crucial that it is properly respected and properly resourced. Members from all parties have talked about and supported parity of esteem between physical health and mental health. It might be useful—this is not in the new clause, but we are talking about the issue more broadly—if at some point the Government could give some clarity on, if not a formal definition of, what parity of esteem means.
Parity of esteem is not as simple as how much we spend on physical health and how much we spend on mental health. That is clearly a guide and an easier  thing to measure, but it seems to me that if we really mean parity, we should look at not only at the inputs—the money we put into the system—but the outputs. Are we seeing an improvement in access to mental health services? Are we seeing fewer people not being referred with the speed that they and the system expect? What outputs should we look for, and should they not be measured in some way in an annual statement?
New clause 9 would go further than the Opposition amendment, which looks to measure inputs and money, and would require the Government to do something broader and ultimately more meaningful to the British people, whichever quarter of the United Kingdom they come from.

Philippa Whitford: We have discussed today, and on many other occasions, the issues relating to child and adolescent mental health and the pressure that young people are under right across the UK, and training for teachers to support them in schools was mentioned. In Scotland, we are putting 350 counsellors into schools. Does the hon. Lady recognise that putting that level of investment into education, where these young people are, would reduce the pressure on CAMHS, and that any assessment would need to include that? If children end up in CAMHS who do not need to be there and who could have been helped earlier, that is also a failure.

Anne Marie Morris: The hon. Lady makes an apposite and correct point. We cannot talk about mental health just within the health and care bucket, so to speak. What do we do to help young mums? What do we do in the school environment for youngsters, who are increasingly put under huge pressure, with cases of stress and depression growing daily? What are we doing in the workplace? Historically, mental health has been something that we do not talk about; indeed, people almost dare not to for fear of being demoted and losing their job. There are many aspects of mental health that need to be taken into account if we are truly to deliver parity of esteem. I would like to think that the Government, and perhaps the Minister when he responds to the debate, would acknowledge the breadth of the need to work together across Government Departments so that we look properly at the outcomes and at the different pieces that affect those outcomes, which go well beyond the Minister’s particular brief.

Daniel Poulter: I thank my hon. Friend for giving way. She is making some very good points. An interesting amendment has been tabled by the hon. Member for Twickenham (Munira Wilson) on the need for greater transparency more generally in mental health funding. It is difficult to understand properly what level of investment is currently going into mental health services, be it CAMHS or general adult mental health services. Would it not be a good thing if the Government took on board the spirit of that amendment and published data on mental health spend on an annual basis across all mental health services, from CAMHS and general adult to older adult and learning disability services? That would help to make the argument that money is actually going into what has been a Cinderella service for far too long.

Anne Marie Morris: My hon. Friend is right in that the things that are relevant to mental health cannot exclude the budgets in other parts of the system. He is  absolutely right, as the hon. Member for Twickenham (Munira Wilson) is, that these things need to be looked at together. Yes, I certainly agree that a written report that sets out what money is being spent where would be very welcome, but I guess that my amendment goes beyond that and says that we should be sure that we are getting something for that money, rather than simply putting in that money and not having any grasp as to whether it is actually making a difference, which is crucial.

John Redwood: I should like to reinforce that point. I in my constituency, as she in hers no doubt, have need that should be tackled and that requires support and treatment, but it is important that it is worthwhile treatment under the right protocol so that things get better. I would value much more information on who is being treated and whether the treatment is working rather than more information on money.

Anne Marie Morris: That point is extremely well made. Let me say, if I may, that there is also a challenge for any Government to be able to properly ascertain what the actual need is. There is a lot of hidden need. In rural communities such as mine, the real challenge lies with isolated elderly people and with lone workers—whether it be a farmer or a policeman. We know that farmers have the highest rate of suicide of any profession. Much of that mental health challenge is not understood or measured, which makes it critical that we look at that need and then, as my right hon. Friend sets out, make sure that what we do properly meets that need. He is absolutely right.

Munira Wilson: I agree with the hon. Lady’s point about measuring outputs as well as inputs, but does she agree that one of the big challenges with CAMHS is the real dearth of data? There are many gaps in the data that is collected. I make this point advisedly, because there is another challenge in gathering more data. I have been lobbied in my own constituency by a charity supporting children and young people with mental health issues. Its funding has been put under threat by NHS England unless it starts to report the date of birth of the young people accessing its service and other information, which then undermines the anonymity that it guarantees to those children and young people, so reporting on the outputs is not actually that straightforward.

Anne Marie Morris: The hon. Lady makes a very good point—I think there are probably two points there. The first is what we should be measuring and when, and the second is about data and the privacy issue. The points are related, but separate. The first one, which is about measurement, is a point very well made. Certainly, the point at which my constituents are counted as being in the box and in need and being referred for mental health can be very far down the line from their first presentation. The figures will often not properly represent the number of people who are actually in need, so I think she is right that we need to be clear at what point we measure an individual coming into the system. I am not clear from what I have heard anecdotally that it is. Some clarity and perhaps an investigation into that would be very helpful. The hon. Lady’s point about privacy is a much broader issue, and I think it would be  beyond the scope of this debate to look at it now. The point was well made, but it is a much bigger point for another day.
Through new clause 9, I am asking for an annual report that would show how mental health provision has improved. Such a report would state how we identified what we included in the mental health bucket that I mentioned; how we identified who is in need; how we measured whether that individual received an intervention, and whether any such intervention was timely; whether the individual’s condition has improved or got better; and how any improvement has been assessed, because that can be a very difficult question. I appreciate that for many individuals with mental health concerns, these are lifelong conditions. We would therefore not simply be measuring whether somebody is “cured”, but looking at the level of improvement and the extent to which the intervention has helped—or not helped—that particular individual. It is very complicated.
My new clause would require the Government to look specifically at how we are going to measure the extent to which we have been able to prevent mental health problems. Specifically, we need to start looking at the support we give in schools, to pregnant mothers and in many other situations. This provision would also require information on how we have diagnosed mental health problems. Too often in constituents’ cases, I find that it is only when a diagnosis is finally and formally made that there is any intervention or help. I have heard from a number of parents of young children and teenagers who have faced problems such as eating disorders and attempted suicide, but much to my concern and that of the parents, as no diagnosis has yet been made—because they cannot get an appointment and so on—the individual youngster who is self-harming is not yet considered to have a mental health problem. The consequence is that they do not get the support and assistance they need, so diagnosis is very important.

Steve Brine: I support what my hon. Friend is saying in her new clause about outputs. This is an issue that I tried to address—and failed, I readily admit—when I was the primary care Minister. She will be aware of the NCT’s Hidden Half campaign, which aims to improve the six-week postnatal check. Does she agree that there are opportunities for the NHS to make an intervention and assessment, but that those opportunities are currently missed? For example, we should be changing the GP contract so that when new mums go for the six-week check with their babies, they get a maternal mental health check at the same time. There are already opportunities, but we are missing them.

Anne Marie Morris: My hon. Friend makes an excellent point. Just like physical health checks, which are very much part of the standard GP system, mental health checks should equally be a part of the standard checks that take place when people present at surgeries. I entirely agree.

Philippa Whitford: Does the hon. Member recognise that we all know what we should be doing to look after our physical health—there is a handful of five key points—but that most of us have no idea what we should be doing to look after our mental health? As well as talking about primary care in schools and workplaces and public  campaigns, we should all be being taught how to develop our own resilience and how to look after our own mental health better.

Anne Marie Morris: That is one of the best points that I have heard in this debate, and it is extremely well made. However, it is a real challenge trying to help individuals to accept even that they might be vulnerable to mental health problems, because it has been such a taboo—let alone the second stage of learning what we can do to try, as the hon. Lady says, to make ourselves resilient. I am pleased that we are having mindfulness classes across the House, not just for MPs but for our researchers. That is not the total solution, but it is at least a step in the right direction. However, her point is about something much bigger than just an intervention—it relates to a big piece missing from this whole agenda. We spend a lot of time talking about illness and not enough time talking about wellness.

Philippa Whitford: Is it not particular to mental health that when we use the phrase “mental health” we actually mean illness? We all have mental health, sometimes good and sometimes bad. If we changed the language, it might be easier for people to talk about.

Anne Marie Morris: The hon. Lady is absolutely right. The challenge, as she recognises, is how we change the language in a way that is accepted and becomes the norm. Part of this is having a much greater focus, as I hope the Secretary of State and his team ultimately will, on wellness, because that is absolutely as important as dealing with the illness when it happens.
We need to remember that in terms of stages of intervention, the whole lifecycle is not just about birth, education and the workplace; it is also about the elderly and veterans, for whom there is often not as much done to identify need and provide support. An older person in a rural area will often have the need but because they are simply out of scope—under the radar—they will, for a very long time, suffer in silence to a point beyond which they cannot be helped. The challenge of mental wellness/illness for older people needs to be a specific focus.
For all that we say, and rightly, about the importance of ensuring that our veterans are properly diagnosed and properly supported, I am certainly conscious of veterans in my constituency who are struggling to get help and support, or even an initial diagnosis. Sometimes the support they need is so complex that they can only get it in London. For somebody who does not have good mental health, the journey from Devon right the way up to London is something they simply cannot conceive of and make a reality.
I am extremely grateful to the Minister for sitting and listening to my thoughts, and for understanding my approach in terms of looking at this in a much more holistic way and seeing how we might measure and report on it so that we can demonstrate to people that we are making progress on parity of esteem. We should look at inputs as well as outputs. I look forward with a great deal of interest to his reply on the points that have been made, particularly on outputs in mental health.

Preet Kaur Gill: I rise to speak to the amendments in my name and the names of my colleagues.
As we have all heard, our NHS needs to be properly resourced in both physical and mental health, but far too often patients are losing out under this Government, with longer waiting times, a huge increase in cancelled operations, and crumbling hospitals. Colleagues have already raised these important issues. I urge the Government to accept the amendments in the name of the Leader of the Opposition as a real signal of their intent to reverse the damage that their party has done to our national health service over the past 10 years.
My amendments focus specifically on mental health. The Government have made much of the need to ensure parity of esteem. This would mean us valuing mental health equally with physical health and adopting an approach that tackles it using the same standards that we expect for physical health patient treatment as a template for treatment that we provide for mental health patients.
I have heard warm words from the Prime Minister, the Secretary of State and Ministers about the importance of mental health and the growing need to tackle mental ill health as an urgent priority, but I have not yet seen that wholehearted commitment manifest itself in actions to tackle the situation we are in. The British Medical Association found that the mental health workforce has had little growth over the last 10 years. The Royal College of Psychiatrists found that the rate of unfilled NHS consultant psychiatrist posts in England has doubled in the last six years. The first briefing paper from the Centre for Mental Health’s Commission for Equality in Mental Health found that mental health inequalities are closely linked to wider injustices in society. Far too many patients with a mental illness are still being sent hundreds of miles away from home.
By accepting the amendments in my name, the Government would show that they are willing to be transparent about the way they go about achieving their long-stated aim of parity of esteem. The Government have already shown, with the presentation of this Bill, that they think it is a good idea to commit, in law, to a minimum allotment that the Secretary of State will make to the health service in England in each financial year for the next four years. That is designed to show that their promise is legally binding and can be scrutinised by Parliament and the public if they do not reach those targets.
To ensure that our mental health services are properly resourced and truly responsive to the various complex conditions that people present with, the public need to know how much is being spent, including how much is being proposed, and what happens in practice. That is all my amendments seek to do—they would provide Parliament and the public with the opportunity to compare the proposed allotment with the final allotment across different years.
Of course, that is not enough, and it is clear that additional resources for mental health services are only one part of the answer to tackling the mental health problems in this country. We know that education and training services are essential to bring about the necessary increase in the workforce. We know that local government provides significant elements of mental health support through public health, youth services, housing and social  care, and two thirds of schools fund their own mental health support. We also know that the Government’s roll-out of universal credit will exacerbate mental health inequalities, which all too often relate to people’s economic and social circumstances. This is not the time to go into those in detail, but I urge the Government to remember the need for those essential services to have a long-term funding settlement and, in the case of social care, an agreed basis for future financing. With ambitious targets to meet in the long-term plan, there is a risk that resources will be diverted from other areas of mental health support to achieve compliance.
I would like to invite colleagues across the House to join me on Thursday for my adjournment debate on Children’s Mental Health Week, which is this week, to discuss these issues further. I know what a commitment to transparency on mental health spending would mean for all those suffering mental ill health and those fighting for them. I hope that the Secretary of State will accept amendment 1 and new clause 1, to ensure that mental health services get a fair deal from the legislation and that pledges made by the Government and NHS England are realised in practice.

Bim Afolami: It is a pleasure to speak in this debate, because it is a rare one in so far as there is quite a lot of agreement across the Committee on the substance of it. There appears to be agreement—I await an intervention if anybody disagrees with this—that increasing funding for the NHS is a good thing, that it is good that mental health is a Government priority and that it is very important to establish what parity of esteem means in practical terms.
I would like to take this opportunity to describe what I have seen in my constituency in terms of the importance of mental health and how the increased funding will make a practical difference. One way in which the funding will make a difference is with mental health support teams. There are mental health support teams in 25 areas in the country. Hertfordshire was picked as one of those 25 areas, and we have two teams—one in my constituency, and one just outside it—that effectively piloted a hub-and-spoke model. As the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) said, it is Children’s Mental Health Week, and the aim of that model is to ensure that young people get better mental health support in and around their school, working in conjunction with the NHS.
As I have seen in my constituency and everywhere I go, when I speak to young people, one of the first things they ask me is, “How can we improve mental health?” Whenever I have spoken to young people, their teachers or local NHS staff, they say this model has the potential, as it is rolled out and developed over the coming months and years, to make a real, fundamental difference. If people are looking for the practical impact of our increased funding for mental health, these teams are one way in which we are already starting to make a difference, not just in my constituency but across the country.
I would like to mention a couple of charities I am involved with that are starting to work in an integrated way with the NHS in improving young people’s mental health. There is a charity called GRIT—a word in politics that we should all remember—or Growing Resilience in Teens. It was set up by a fantastic doctor in  Hitchin called Dr Louise Chapman, and it does what it says on the tin: it is about growing resilience in mental health.
As politicians, when it comes to legislation or speaking to each other in the Chamber or outside, we think often about pounds and pence and talk about structures such as hospitals and stuff that can be measured in a very easy way, or at least what we think is an easy way. However, growing resilience is one of the things we need to ensure the NHS does more effectively. Not just in mental health, but particularly in mental health, growing resilience in our young people is an integral part of prevention. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), talked about that in his speech, saying that half of mental health problems are established before a young person is 14.
We need to grow resilience among young people to future-proof each and every one of us, and our communities and our society, against serious mental health problems in the future, at the same time as investing in mental health services such as CAMHS, which has already been mentioned several times in this debate. However, we need to do both: to grow resilience and to improve the institutional frameworks. Again, that is what the money this Bill is providing will go towards.
Another charity is called Tilehouse Counselling, which again is based in Hitchin. I do not mean to say that Hitchin has all the charities in my constituency, but in this area Hitchin is a real regional leader and, indeed, a national leader. Tilehouse Counselling provides counselling services to young people, and young people often find themselves at Tilehouse when CAMHS does not have the capacity.
I urge the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is on the Treasury Bench—she knows this because everybody knows how much she cares about the NHS, how much she knows about it and her own personal experience in it as a professional—to use the money provided by this Bill to increase the workforce and to improve the state of CAMHS so that it can treat more people. Again, that means helping the mental health hubs to work with young people and the education system to improve prevention and, when mental health intervention is needed later on if things have got more serious, making sure that CAMHS has more capacity. Again, the money in this Bill will help to provide that.
Another new organisation in my constituency is called GoVox. It has already been in discussions with NHS Digital, and NHSX, about online ways of improving mental health for young people. Increasing funding matters, and it is always worth stating and restating in the Bill that these are minimum numbers, not maximum numbers. This money is hugely needed, and it should make a big practical difference.
On the pleas from Opposition Members—in relation to new clauses 1, 2 and 9, and a few others, which say that the Government must report on this or must do that—I urge the Minister for Health to commit in his response to showing how he and the Government will improve the existing reporting procedures and mechanisms so that the House can be kept fully informed. My right hon. Friend the Member for Wokingham (John Redwood) spoke about how Members of Parliament often feel  distant, not from information about funding, but from outcomes. Will the Minister explain how the Government could improve that delivery mechanism, as that would allay some concerns across the Committee?
New clause 10 is fairly ridiculous as it is a rehash of the argument that we had at the back end of last year—[Interruption.] It has not been selected. You agree with me, Dame Rosie, so I do not need to talk about how ridiculous it is. [Interruption.] Forgive me. Dame Rosie has no view, and it is important to put that on the record.
In the context of the Bill, we must remember what we are here for. I speak with generosity to Labour Members who I know care deeply about the NHS, but we are not here to try to score points; we are here to improve the state of our NHS. Everybody recognises that this is a good Bill, yet many of the amendments appear designed to create some sort of artificial dividing line between Members on this side of the Committee and that side, regarding who cares the most about the NHS or mental health. I urge all hon. Members to remember that the purpose of this Bill is to increase funding to our NHS and improve our mental health services, and I therefore do not support the amendments.

Munira Wilson: I wish to speak to new clause 2, which is tabled in my name and those of my Liberal Democrat colleagues. As you know, Dame Rosie, I intended to push the new clause to a vote, but I understand that time pressures will not allow me to do so. I am disappointed by that, but I will be pressing the Government on this issue time and again. I want them to make it a high priority and to put it at the forefront of their policy making and commitments to the mental health of children and young people.
It is a pleasure to hear such a unified voice across the Committee about the importance of mental health, and there is a clear commitment to parity of esteem and to ensuring that mental health across the board gets the funding it deserves. I am therefore encouraged by the amendments, many of which I and my colleagues will support.
New clause 2 focuses specifically on the crisis—I used that word advisedly—in the provision of child and adolescent mental health services. It places a spotlight on the chronic underfunding of CAMHS, and seeks to encourage the Government and NHS England to deliver on their promises and improve transparency and accountability on those priorities.
Before I arrived in this place, I was aware of this significant and pressing issue. Less than two months since my election, however, I am utterly horrified by the cases of children and young people in crisis that cross my desk on a weekly basis—or more often—either through my surgery, my inbox, or anecdotally when speaking to acquaintances and contacts in my constituency and well beyond. New clause 2 seeks to make the Government and NHS England more accountable for the funding that they provide annually to CAMHS. That is very much in the spirit of the Bill. The Government are seeking to codify their promised expenditure on the NHS, and the new clause seeks simply to do the same  thing in this important area, given that a number of welcome commitments have been made about CAMHS spending.
There are concerns that that funding is not reaching the frontline. Indeed, the evidence is clear. Just last week a report by the Children’s Commissioner stated that many CCGs are spending less than 1% of their mental health budget on children and young people. In 2017, the CQC revealed that CCGs have prioritised adult mental health over CAMHS because of the need to ration services. Other amendments seek to talk about mental health more broadly, but that is the reason why we need a particular spotlight on children and young people’s services.
The phrasing of new clause 2 seeks to ensure accountability against the ambitions of the long-term plan. Subsection (2) would help to demonstrate whether the promises on the growth of CAMHS spending outstripping mental health spending, and NHS spending across the board, are kept.
Subsection (3) shines a spotlight on regional variability. The Children’s Commissioner’s report last week talked about the enormous postcode lottery of spending on services. The numbers cited were staggering. In terms of low-level services, they ranged from 72p in some areas to £172 per child. On specialist services, they ranged from £14 to £191. We all expect some level of variation, but I am sure the Government would agree that that level of variation is utterly unacceptable. It needs to be tracked very publicly, so that spending and services can be improved to meet need.
Why is that so critical? As has been stated by various Members, half of all mental health problems are established by the age of 14. We know that 1.25 million children and young people had a mental health disorder in 2017. We have heard that since 2010 there has been an increase of 330% in admissions to A&E of children and young people diagnosed with a psychiatric condition. We know that only one in four children and young people is being seen by a specialist when they need to.
It is very easy to cite statistics, but behind them are individuals: children and young people and their stories. The stories I have heard are of teenagers self-harming, teenagers who are suicidal, teenagers who are a danger to themselves and their families, and young people who are excluded from school or are taking themselves out of school because of their mental health conditions. One piece of correspondence I received from a parent talked about her 17-year-old being referred for specialist treatment last November. He might be assessed, if he is lucky, in March and he will not get treatment for four to six months after that. That cannot be right. This child has at times been suicidal. I have also had a case of a 10-year-old with tier 3 needs waiting a similar amount of time for the initial choice assessment, who will be waiting a similar amount of time again for treatment.
We have had many plans, many vision documents and many strategies setting out wonderful lofty ambitions for the NHS. As I said, the long-term plan has some very laudable commitments on CAMHS. The Bill seeks to put into law what the Government promise on NHS spending. New clause 3 simply seeks to put into law the Government’s promises on spending on children and young people’s mental health disorders. I cannot press new clause 3 to a Division, but I very much hope that the Government will accept the spirit of my new clause  and look to see what measures they can put in place to improve transparency and accountability. We owe it to those children and young people, because this really is a crisis and they need us to step up to the plate.
I will end my remarks with a quote from the mother of the 17-year-old I referred to earlier, because she puts it far better than I could:
“All these young people are our future and if we do not help them now, we are looking at a bleak future as these young people will end up being isolated from society, lack skills for work and relationships, find employment hard, perhaps even get into crime and ultimately will end up not having fulfilled lives and maybe end up being yet another statistic. We have not got this right and it is not just about the budgets or party politics; we need all of you to work together on this and treat this as an emergency.”

Lucy Allan: What a pleasure it has been to listen to so many excellent speeches. In particular, I want to say how much I value the contribution of the former Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Jeremy Hunt)—I am sure that Ministers will have listened to what he said. I thank everybody who has tabled amendments, which are very thoughtful and well considered. I am particularly grateful for the amendment on patient safety, and again, I am sure that Ministers will have heard what has been said on that issue.
It is a pleasure to speak in a debate where we are not politicising something that matters so much to our constituents and where we are coming together to contribute our experiences, either in our constituencies or professionally. For that reason, I am delighted to be speaking.
I do not support the amendments, however well intentioned, well formulated and well thought out many of them are. However, I would like to speak to the amendment on capital budgets because there are some learning opportunities for the Government in how they spend significant capital investment on hospitals, upgrades and reconfigurations of hospital services. Those upgrades and reconfigurations are indeed happening now, as was set out in the manifesto, but they were also happening before that. My constituency and the county of Shropshire have experienced significant capital investment, but there has been a very difficult, painful and protracted process in trying to bring that forward as something that will benefit the whole community and improve patient care across the county.
I raise that issue because I hope that Ministers will take away from that experience the fact that it is fundamentally wrong to have significant capital investment where local communities are pitched against one another, as has happened in Shropshire. We saw local CCGs propose that Telford should lose all its acute services and be stripped of its A&E and women and children’s services, with them being transferred to another community some 20 miles away that is significantly more affluent and has better health outcomes. In addition, it was intended that that community would also receive £312 million of capital investment in new facilities. I am sure that hon. Members can imagine how that would make our community feel, particularly when it is disadvantaged in many respects. It is a growing new town that will have 200,000 residents in the next 10 years. We have to provide services with equal access for all, because as this Government have said, they are about one thing: levelling up. They are about narrowing health inequalities and  ensuring that there is equality of access to health services across our communities. Of course, the NHS has always been about need. Funding in the NHS should follow need.
I will not delay the House too much with further discussion of the situation in my constituency because I believe that my CCGs, after six years of debating this issue, have had another thought about how they might resolve the problem. It will require more Government funding, but they have already made it clear that the proposal that is currently on the table will also require more Government funding. It will provide a fantastic opportunity for us to resolve this situation, which has been ongoing for so long. So, if the Minister is listening to pleas for more capital funding, may I ask that we complete the proposal in Telford, which will be of such value to our community?
There are other learning points that come from the capital investment programme. CCGs and health trusts have a duty—indeed, the Secretary of State has a statutory duty—to narrow health inequalities. We see that across the country where there have been controversial reconfigurations of local hospital trusts and hospital builds. It is not just in Shropshire either; many MPs on both sides of the House have spoken of the need to narrow health inequalities and to ensure that more affluent communities do not benefit at the expense of more disadvantaged ones. This new Government could not tolerate that continuing in areas of disadvantage.
My third and final point is another that many colleagues on both sides of the House have made already. The CCGs, which make these decisions on behalf of communities, are accountable to no one and, regrettably, take no notice of what local communities say. They might conduct a consultation, as with the Shropshire reconfiguration, but they take no notice of what local people say. They certainly take no notice of local representatives—of the MPs and local councils—and sometimes they appear disinclined to take much notice of the Secretary of State. I am very grateful to him for spending a great deal of time trying to resolve this issue, although the CCG was not particularly impressed with his proposal, which I thought was excellent and would have benefited my community.
CCGs often operate as if they were directors of a FTSE 100 company, with all the trimmings but without the checks and balances that shareholders provide. Without accountability we see abuses of power, conflicts of interest and a failure to serve local communities. It is almost impossible to remove a non-performing chief executive or board, and in any event they just pop up somewhere else with their golden handshake and gold-plated pension still intact.
I genuinely believe that we now have a window of opportunity to solve the Shropshire reconfiguration, and I deeply hope that Ministers can help us to bring it to a long overdue conclusion. If we can learn anything from our experience, it is that we have a decision-making structure in the NHS that does not serve the communities it is intended to serve and which is not accountable to us, and if it is not unaccountable to MPs, to local councils or to individual residents and patients, there is a problem. We need a full examination to ensure that what has happened in Shropshire does not happen  again. I am hopeful for my constituents and neighbouring Shropshire MPs that there is a solution on the horizon, and one that would be a positive outcome for all our communities.
That said, our communities should not have had to resort to crowdfunding a legal action against the CCG or the Government, or to protests, marches and petitions, and they should not have had to endure six years of uncertainty or to write thousands of letters to their MP. As the Government embark on this welcome capital expenditure programme—a truly historic investment programme that we all welcome on both sides of the House—I hope they will look at what has happened in the NHS Future Fit process in Shropshire and learn the lessons of that experience so that those mistakes are not repeated.
To conclude, I reiterate what a pleasure it is to take part in a debate where everybody is trying to get the best outcome for their constituents, the country and the NHS in terms of the service it delivers to all our constituents.

Alex Cunningham: You, Dame Eleanor, were not in the Chamber when the hon. Member for Glasgow North (Patrick Grady) indicated that SNP Members might pass through the Lobby, although of course they will not be counted. I seek your help. I want to make sure that the Government Whips do not get confused by my accent and count my vote on behalf of the people of Stockton North when I support the amendment.

Eleanor Laing: The hon. Gentleman asks for clarification and raises a point that I have many times had cause to raise myself, so I am in total sympathy with him, and I am quite sure that his plea has been heard.

Alex Cunningham: I am very grateful, Madam Deputy Speaker.
Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.
It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.
There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting  for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.
At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.
It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.
There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.
We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.
Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I  referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.
We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.
In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.

Edward Argar: indicated assent.

Alex Cunningham: I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.

Suella Braverman: I rise to speak in favour of the clauses in the Bill and against the amendments. I do not think that the latter add anything material, and they ignore the vast improvements in mental health under this Government in recent years. One in four adults will experience mental health illness in their lifetime, and that is obviously a high incidence of mental health illness. It shows the growing concern around this issue as well as a growing awareness, and, I have to add, a growing commitment by today’s Government, but we cannot ignore the fact that there are many challenges in the system and many areas for improvement.
I want to talk briefly about the Government’s record. I fully support their commitment to providing funding for mental health services, which will mean that those services’ funding will increase faster than in other areas of the NHS. I hope that much of that funding will go towards the frontline in teaching and education. Perhaps the Minister will address this in his closing remarks.
I meet many education professionals in Fareham who report an increase in the incidence of mental illness among their young people and finding the cost of providing counselling and support an additional burden on their budgets.
It is important to note that by 2023-24, under the proposals in the Bill, at least an additional 345,000 children and young people under 25 will be able to access support via NHS-funded mental health services.  That is a welcome aim, and I am confident that we will meet that target under this landmark funding commitment. That progress is hugely welcome, and I am glad that the Government have made children and young people’s mental health a top priority within the NHS, which is halfway through a major programme to improve access to specialist services, supported by £1.4 billion of funding. I congratulate the Front-Bench team and the Government on that work.
I want to talk about some of the incidents that I have come across in Fareham over the past few months. Tragically, several young people took their own lives last year. As I said earlier, I recently met educational professionals who are increasingly worried about how long it is taking young people to access mental health support, counselling or other support through CAMHS. Children or young people are presenting with problems such as anxiety, low-level depression or self-harm, but they are not necessarily meeting the eligibility criteria required by CAMHS, so they are not being accepted for treatment by the services on offer. That leaves them to fall into a treatment gap, which is a problem in Fareham and around the country. Young people are presenting with complex needs that do not necessarily fit into the diagnostic box, and I hope that measures are in place to provide more accessible lower-level care and treatment to meet that demand.
The other issue that young people, their families and teachers, and medical professionals in Fareham are reporting to me is the time it takes to get an initial counselling or therapy session through CAMHS. Young people sometimes have to wait months before an initial meeting, which can have a devastating effect on someone who might be fragile or facing challenges. They may end up dropping out of school, for example, but they may have stayed in school had there been some intervention, or they may increase their level of self-harm or become suicidal within that timeframe. It is tragic that systemic challenges mean that we are unable to reach maybe the easier-to-treat cases in an appropriate timescale. It is incumbent upon me to highlight the challenges we are facing in Fareham, but I am glad that this funding and this commitment to mental health, particularly children and young people’s mental health, will go towards improving some of those systemic problems, such as resources and waiting times.
Turning to some good news in Fareham and the progress being made to address the treatment gap, I am pleased to welcome a new community support project in Fareham and Gosport that has been set up to supplement the existing health service. It is run by the Southern Health NHS Foundation Trust and the Princess Royal Trust For Carers, and a consultation is under way to assess how it can focus more on day-to-day mental health challenges and provide lower-level support for people who do not necessarily fulfil the eligibility criteria that I set out. That might be someone who has lost a job or is facing some financial difficulty, and this support can help them to get through a troubled time and prevent them from deteriorating.
The project will support people on a one-to-one basis and will serve to ease pressure on other services. It aims to nip mental health problems in the bud before they get worse, with a focus on prevention and on flexibility.  I really welcome the initiative and hope that if it is successful in Fareham and Gosport it will be rolled out further afield in Hampshire.
I also want to talk about the Southern Health NHS Foundation Trust, which provides mental health services in Fareham. I want to update the House on the good progress that Southern Health has been making. I have been campaigning for many years—in fact, it was one of the first issues that hit my in-tray when I was first elected in 2015—about the systemic and structural problems endemic in the health trust, which was, frankly, failing its patients back in 2014 and 2015. Its leadership has been overhauled and it has had huge interventions from NHS Improvement, as well as a lot of monitoring from the various regulatory bodies in relation to its history of treatment of people with serious mental health problems or with disabilities, including avoidable deaths. Several inquests have concluded that Southern Health did bear blame for those deaths.
I am very glad to report that last week the CQC reported that Southern Health trust should be rated as good, and that is a vast improvement on previous years. It is a vote of confidence in the leadership team, and it is a real step forward in providing confidence to the thousands of people who work for Southern Health, and of course, above all, those patients who are under its care. In terms of leadership, safety, caring responsiveness and the extent to which it is patient-centred, Southern Health was rated as good. I have to say, however, that some areas still require improvement—for example, the effectiveness of services.
I have worked with many families whose young relatives have taken their own lives under the care of Southern Health, and I know they have been significantly involved with helping to get improvements in Southern Health. I know that they will be pleased by last week’s CQC rating, and I want to congratulate those families on all their input and their work on this issue. I also congratulate the leadership team at Southern Health.
Lastly, I want to talk briefly about Fareham Community Hospital in Fareham, which has been my pet project. It is a wonderful facility in the heart of our community, but it is sadly under-used. Last year I conducted a wide-ranging consultation with hundreds of local residents and many stakeholders, and I authored a document on the conclusions: the Minister is welcome to read a copy, maybe tonight or tomorrow, if he would be interested. It sets out a plan, based on the results of that consultation, for how we can better use Fareham Community Hospital. One of our recommendations is that it would be a brilliant location for a mental health hub in our community. We have a great facility, which is well located and in good condition, but in the light of the demands and challenges in the local area with young people’s mental health there is a great opportunity here for more funding and more co-ordination so that Fareham Community Hospital can be better harnessed, so that our young people, and also other people who need mental health support, can use the facility and capitalise on it in the most effective way. I hope that bosses at the CCG and those who make the decisions will that bear in mind.
I applaud the Government for their commitment to the funding in the Bill, and I oppose all the amendments.

Laura Trott: Members across the House have spoken about the importance of unanimity of purpose on mental health and maternity, but I want  to speak against amendments 2 and 5, for the simple reason that this funding, although so welcome and necessary in my constituency—and those of Members across the House—will be useless to my constituents unless it results in improved outcomes. Rather than talking about ring-fencing funding for specific things, we should be talking about outcomes—what they mean for our constituents, and how we make their healthcare better.
My hon. Friends the Members for Newton Abbot (Anne Marie Morris) and for Hitchin and Harpenden (Bim Afolami) raised similar points. The hon. Member for Ellesmere Port and Neston (Justin Madders) rightly drew attention to the ambitious targets in the NHS long term plan. Those are the targets that we should be tracking ourselves against. Those are the targets that we should be talking about, and we should monitor whether the improved funding has enabled us to make progress against them. We should not just talk about whether to put a certain amount of money into a certain pot; on its own, it makes no sense and will not make anyone’s life better. The main point I want to make is that we should focus on outcomes rather than forever tracking inputs that do not improve our constituents’ lives.
The NHS long term plan has some very ambitious targets for maternity and mental health. I shall dwell on the target to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by 2025. It is incredibly important, and it is crucial that the House is updated on our progress against it. We shall do that, yes, through funding, but funding linked with policies that will drive that outcome and drive improvements.
I want to focus on midwives and maternity care. Under the coalition Government, a commitment was made to give each mother a named midwife. That is obviously extremely important, both for the mental health of the mother and for her care, because it means that there is someone who, throughout, is observing how that woman is doing—understanding how she has changed from one appointment to the next. It is not just a tick-box exercise, with a person who has never met the mother before looking at a list and saying, “Have you actually done this? Then you must be fine.” It is a person looking at the woman and thinking, “Actually, is this someone who needs a bit of help—whose mental health has deteriorated since the last appointment, who is looking a little bit more anxious?” Ring-fencing the funding is not enough in itself.
In addition, the long term plan talks about the shortage of neonatal capacity. As someone who has had the misfortune to have to use a neonatal unit recently, I know the tragic and immense strain that the movement of babies can put on parents who have to use neonatal units. We absolutely must put this money into expanding capacity in our neonatal units, and try to ensure that parents are assured that when they move into high-dependency units, they will never be downgraded because of capacity. That is incredibly important.
My hon. Friend the Member for Telford (Lucy Allan) spoke very movingly about the issues that she had in her trust. Moving forward with policies such as these will prevent any repeat of such issues.
On a linked issue, it is important that we look at outcomes for multiple births. Neonatal capacity is part of that, but in addition the Twins Trust has been doing  fantastic work in terms of a maternity checklist, which has been piloted by a number of trusts but not yet all. We can look at funnelling some of the money into increasing those trials. That will drive outcomes, which is what we are all here to ensure.
Finally, I want to mention money for anaesthetists. We talk about mental health outcomes for mothers. Part of the problem has been that, according to frightening reports, women who are in terrible need of pain relief during childbirth have not been able to get it. That is a cultural issue in some trusts. They seem to view childbirth as different from having an operation on one’s leg. I would like to see anyone who would undergo an operation on any other part of their body without pain relief, but that seems to be something that some trusts believe women are able to do, and it is wrong. Investment in anaesthetists, and funnelling money into that area of the NHS, is incredibly important.
To summarise: outcomes, please, not just pots of money. That will make everyone’s constituents’ lives better.

Lee Rowley: It is a pleasure to follow my hon. Friend the Member for Sevenoaks (Laura Trott), not least because her last sentence is what the next 10 minutes of my speech are about. [Interruption.] I am sure many Members probably want me to sit down now, but I will continue none the less.
May I welcome the Bill in general before dealing with the amendments I wish to speak about? It provides useful and good clarity for all the hospitals around the country, which need to ensure that they have appropriate funding in the coming years. I also welcome the clarity on the revenue side for hospitals such as Chesterfield Royal Hospital, which serves my constituency. It is looking for additional support on not only the revenue side, but the capital side, although I know that this is not the debate for that. I will not be supporting amendment 3, but there was a lot of merit in it, if only to ensure that if we do get our urgent care village at Chesterfield Royal Hospital, we could thus ensure that the money is in place and is ploughed into proper capital upgrades for the hospital in the future, for the benefit of everybody in north Derbyshire and my constituency.
I also welcome the Government’s commitment in recent months to the output point that my hon. Friend the Member for Sevenoaks outlined. That was done to some extent during the general election campaign, and I look forward to the continuation and extension of that in the coming months and years. I am pleased that we are in a debate on the NHS and healthcare that, as my hon. Friend the Member for Telford (Lucy Allan) said, has been relatively friendly and has come away from the usual histrionic fireworks that sometimes accompany this issue. It is helpful for us occasionally to step back and have this kind of debate on the NHS, given that we are all committed to improving healthcare in our constituencies.
I wish to discuss two of the amendments briefly, picking up on this point about outputs. The hon. Member for Ellesmere Port and Neston (Justin Madders), speaking from the Opposition Front Bench, was right about the need for accountability and the need to ensure that the money being committed in this Bill is spent wisely and  appropriately, as was my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who is no longer in his place but who talked about this not just being about money, and my hon. Friend the Member for Newton Abbot (Anne Marie Morris), who is also no longer in her place but who was also keen to highlight the importance of outputs. For reasons I will talk about if I have time at the end, it is particularly important for me, on a personal level, that we focus on outputs.
First, let me turn to new clause 4, which I am keen to examine. I congratulate the Opposition Front-Bench team on beginning the long road back to sense—I hope they do not mind my describing it as such—with their welcome return to an interest in healthcare outputs rather than solely in inputs or methods. That is something to welcome, but the problem, and the reason I cannot support these proposals tonight, is that the Opposition continue to mix up the point about targets and outputs. Targets are not ends in themselves. Targets are indicative, much as we wish them to be hit and important as they are, to ensure that they give us good guides as to what is happening in our hospitals and healthcare system. They are different from outputs. In time, I would be keen to see Opposition Front Benchers moving further down that metaphorical road towards recognising that the outputs are the most important thing: people getting well, staying well for longer; going home and living longer and more meaningful lives with their families and within their communities.
The new clause also slightly misses the point. I infer, as clearly one can, that it starts from a position of directly relating the requests made to set out things from the perspective of money. I do not doubt that money is vital in this discussion, which is why we are bringing forward this Bill, but it does slightly become a blunt instrument. An opportunity is missed to recognise that this is not simply about money. The inputs into our healthcare system are incredibly important, but so are the structure, the model, the operations, the behaviour within it, the technology and the prioritisation chosen by all that vast behemoth of bureaucracy around the NHS. We have to ensure that there is a recognition of the importance of that, and that there is a real effect on the output at the end and on making sure that people stay better for longer. On that basis, I cannot support new clause 4.
New clause 11 is a similar attempt by the Opposition to ensure annual reviews of the adequacy of the financial movement forward. My challenge is that there is a definitional problem. The new clause would require the consideration of
“an assessment of the extent to which changes in the costs of…service delivery”
affect outcomes. There is an interesting question about the definition of “service delivery”, whether it is a rather narrow assessment or could encompass everything that the NHS ever does, and whether that would provide any benefit to the House or anybody who used the assessments. There is also a question about the complexity of analysis of service delivery in the first instance and how that can be defined and assessed. As a former management consultant, I am all in favour of complex analyses, but ultimately they have to provide a utility appropriate to what we are trying to do and to the ultimate objective and end point.
Although I again compliment the Opposition on moving closer towards output-based consideration, new clause 11 also starts from the position that money alone is the ultimate arbiter of whether our healthcare system is successful. Again, it is not just about money, as important as that money is; it is about organisation, people, motivation, workforce, demand, prioritisation, processes and how technology and innovation are changing things. If we do not recognise that, we are missing out a substantial portion of the debate that will be vital in the next 20 years to ensure that our healthcare system is fit for purpose.
Ultimately, why does this all matter? Why does speaking at a relatively technical level about outputs, structure or processes matter as much as inputs and money? Because, as other people have said, this is about real people—it is about making sure that people live for longer. We have all seen examples, when people come to see us at our surgeries, of where the NHS works wonderfully, but in our heart of hearts we all know examples of where the NHS has worked less well. That focus is sometimes as important as the money.
Let me give the House a personal example. My family, including myself, have had three occasions or reasons to get involved in the NHS over the past few years—indeed, over many years. The NHS saved my life on multiple occasions when I was growing up, and it also saved my father’s life when he had a double heart bypass around 10 years ago. It did less well with my mum when, a few months after I came to this place in September 2017, she was diagnosed with ovarian cancer, about which I have spoken in Westminster Hall. That was an error, errors happen—there are humans in the process—and we have not taken it any further because of that. My mum is still here and I am very happy about that, but ultimately my mum did not have a good experience. If we just focus on money, we miss out on cases such as my mum’s.
We have been lucky in my family, but ultimately there will be constituents of ours who are not lucky. That is the point: I am grateful for the money that is going in, but it has to be well spent. If this place does not consider the outputs—if this place does not understand where the money is going and how it is used—there will be people who do not get through it in the way that we want them to. We all want to stop that, which is why it is really important that we focus on outputs as much as inputs.

Jane Hunt: I am grateful to my east midlands colleague, my hon. Friend the Member for North East Derbyshire (Lee Rowley), for that excellent speech. He made some important points, particularly about outputs, the specific healthcare that is needed and the support required throughout the NHS.
I am grateful for this opportunity to speak to amendments 1, 2 and 3. The funding in the Bill will be administered by NHS England. The Bill guarantees long-term funding to implement the NHS long-term plan. It commits the Government to a £33.9 billion increase for the NHS by 2023-24, bringing the total spend to £148.5 billion. It also provides certainty through a double-lock agreement that places a legal duty on the Secretary of State and the Treasury to uphold this level of funding as a minimum over the next four years.
We are putting our money where our mouth is. Our manifesto clearly stated that
“within the first three months of our new term, we will enshrine in law our fully funded, long-term NHS plan”.
Since our success in December, we have consistently put forward and agreed steps to meet the commitments in our manifesto. We are delivering on the promises that we have made.
One of the most important aspects of the NHS long-term plan is its approach to mental health. It is crucial that people have access to mental health services where and when they need them. I, therefore, welcome the fact that the plan commits to ensuring that mental health receives a growing share of the NHS budget, which will be worth at least a further £2.3 billion a year in real terms by 2023-24. This will enable further service expansion and faster access to community and crisis mental health services for adults and particularly for children and young people.
Given that many people living with mental health issues may need to access health services more often, the NHS long term plan also allows for better and more consistent working between all parts of health care and voluntary elements of the sector. As we have seen in west Leicestershire, for example, primary care networks have formed, grouping GPs and other partners together to the benefit of their patients.
As NHS England sets out, primary care networks build on the core of current primary care services and enable greater provision of proactive, personalised, co-ordinated and more integrated health and social care. Clinicians describe this as a change from reactively providing appointments to proactively caring for the people and the communities that they serve.
Linking this local working together with the benefit and knowledge of vanguard projects from across the country and giving experienced local trust leaders, who have a deep understanding of the physical and mental health needs of their local area, the freedom to make appropriate funding decisions will improve the overall experience of the patient and provide better health and lifestyle outcomes. That is to be welcomed and celebrated, and I ask my fellow colleagues to support the Bill and reject the amendments today.

Patrick Grady: On a point of order, Dame Eleanor. I notice that it is now 5.10 pm and that the Minister is about to get to his feet. If the knife falls at 5.30 pm, while the Minister is still speaking, or a Division is under way, can you confirm that that means there will be no Report stage, and no chance for the SNP amendments to be tabled or voted on?

Eleanor Laing: The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.

Edward Argar: In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.
I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.

Pete Wishart: rose—

Edward Argar: I will give way very briefly, because the hon. Gentleman is eating into his own time.

Pete Wishart: The Minister is in a very accommodating mood. Does he accept that this Bill has funding implications and consequences for health spending in Scotland?

Edward Argar: As has been very clear throughout the progression of this Bill so far, there are Barnett consequentials, which will be dealt with in the usual and appropriate manner.
I will turn to the detail of the amendments in a moment, but before I do, let me say that my hon. Friend the Member for Telford (Lucy Allan) addressed the debate in Westminster Hall just before the general election. In that, I said that if her constituents wanted a strong voice in this place, they should vote for her. I am very pleased that they did exactly that. Her speech shows exactly why.
This legislation is a simple Bill of two clauses. The substantive clause—clause 1—puts a double-lock duty on the Secretary of State and Her Majesty’s Treasury to ensure that NHS England will receive, as a minimum, £33.9 billion extra a year by 2024, enshrining in law the NHS England revenue budget rise in line with the Government’s manifesto commitment. The Bill has deliberately been drawn narrowly to focus on that core commitment.
New clauses 4, 5 and 11 focus on whether the allocations are sufficient. At their heart is the question of whether the quantum is appropriate and will meet the needs of the NHS. Although I understand the sentiment behind these new clauses, they are unnecessary. The chief executive of the NHS said in 2018, after the announcement of the settlement:
“As the NHS turns 70, we can now face the next five years with renewed certainty. This multi-year settlement provides the funding we need to shape a long-term plan for key improvements in cancer, mental health and other critical services.”
We are giving the NHS the funding that it believes it needs.
There is already a clear duty on the Secretary of State for Health to lay before Parliament and publish an annual mandate to NHS England. The mandate sets objectives that NHSE must seek to meet in the year ahead, and its budget for doing so. That budget includes funding to meet all of NHSE’s statutory duties, including duties under the NHS constitution. The Secretary of State has a further duty to keep performance against the mandate under review, and must also publish his annual assessment of this performance in Parliament,  with Parliament entitled to table debates and questions on the matter as it so wishes. Therefore, although I appreciate the purpose behind these new clauses, they would serve no useful additional purpose. Parliament already has ample opportunity to review NHSE’s budget, to consider whether it is sufficient to deliver on the objectives that the Government have set and to hold the Government to account. I will touch a little more on this when addressing new clauses 9 and 2 later.
I turn to new clause 5 and the concerns that the Bill enshrines the NHS budget in cash terms—a point that the shadow Minister has reasonably put to me and to the Secretary of State on previous occasions. Like Government departmental settlements, the NHS budget is set in cash terms. This is essential to deliver certainty and predictability. However, responding to changes or fluctuations in expected inflation rates is part of the normal course of business, and would be addressed and scrutinised as necessary through fiscal events such as Budgets. We do not need to legislate for that separately. Furthermore, the House should remember that what we are proposing is a floor, not a ceiling. We are retaining the flexibility for an increase in funding in a range of scenarios. Nothing in the Bill prevents that at any future point.

Theo Clarke: This Bill is about funding, but buildings and services are key to delivering on our national health service priorities, so may I highlight the importance of the A&E at the County Hospital in Stafford and ensuring that we are supporting NHS services in my constituency?

Edward Argar: My hon. Friend is a sound and vocal champion for her constituents in Stafford. I am sure that she will continue to champion their cause, and I am happy to meet her to discuss the specific issue she raised.
I turn to amendment 3, in respect of capital-to-revenue transfers. Clause 1(2) ensures that the funding specified in the Bill can only be used for NHSE revenue spending, meaning that day-to-day spending for the NHS is protected. As we have highlighted in the House previously, the Government have made a range of capital commitments to the NHS, including the commitment to 40 new hospitals. Nevertheless, going to the point in the amendment itself, we have been clear that the transfers from capital revenue should have only been seen as short-term measures that were rightly being phased out, and we are doing so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, did, however, set out why a degree of flexibility is required, and we would not believe that a blanket ban set in legislation was the right approach.

Gareth Thomas: Will the Minister give way?

Edward Argar: I will not, if the hon. Gentleman will forgive me, as I only have 10 minutes or so left.
There are sometimes very good and logical reasons why adjustments between capital and revenue are needed. As the former Secretary of State highlighted, in some cases, for perfectly good reasons a capital pot may not be spent fully within a year and there is an opportunity to achieve patient good from transferring it. While I take his point and believe it is right that we should continue to move away from such transfers, I would not wish to see that rigidly set in legislation.
Amendments 2 and 1, and new clauses 1, 2, 3 and 9, relate to mental health services both for children and adults, and accountability to Parliament and reporting mechanisms. We have rightly seen considerable interest in mental health in this debate, so I will seek to address both those points together. I begin by paying tribute to Paul Farmer of Mind, Sir Simon Wessely, Professor Louis Appleby, the Mental Health Foundation, Rethink Mental Illness, YoungMinds, the Royal College of Psychiatrists, and a host of other individuals and organisations up and down the country, for their fantastic work in making mental health such a feature in our debates and in the public consciousness. It is absolutely right that they have done so.
I pay tribute to the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who brought to the role of mental health Minister passion, dedication and a determination to make a difference. I should also reference some former Members of this House: Norman Lamb, who did so much in this area; the former Prime Minister, David Cameron; and of course my right hon. Friends the Members for South West Surrey and for Maidenhead (Mrs May), who ensured that it was front and centre of this Government’s commitment.
I want to be totally clear that the Government are fully committed to transforming mental health services. That is why we enshrined in law our commitment to achieving parity of esteem for mental health in the Health and Social Care Act 2012. As my right hon. Friend the Member for South West Surrey said, that is driving real change on the ground. We have also committed to reforming the Mental Health Act 1983 to provide modernised legislation. I would also highlight that at £12.5 billion in 2018-19, spending on mental health services is at its highest ever level.
We have made huge strides in moving towards parity, but there is still so much more to do. We are ensuring, through the NHS long-term plan, that spending on mental health services will increase by an additional £2.3 billion by 2023-24. This historic level of investment in mental health is ensuring that we can drive forward one of the most ambitious reform programmes in Europe. It will ensure that hundreds of thousands of additional people get access to the services they need in the lifetime of the plan. I flag that up because we can and will always strive to do more, and it is right that we are always pressed by this House to do so. While proposals for a ring fence in mental health spending are understandable, the approach that this Government have already set out, with long-term commitments to funding, is already driving the results we wish to see.
I now turn to new clause 9, tabled by my hon. Friend the Member for Newton Abbot (Anne Marie Morris). If I may, I will also address new clause 2 in this context because there is a degree of overlap. I welcome my hon. Friend’s new clause. Although I hope that, as she indicated, she will not press it to a vote—and I heard what the hon. Member for Twickenham (Munira Wilson) said in respect of hers—the sentiment behind it is a good one, particularly the focus on outcomes and outputs rather than simply inputs and the amount of money going in, and on adopting a holistic approach. I know that my hon. Friend the Member for Newton Abbot recently  met the Secretary of State to discuss the matter, and I am happy to meet both her and the hon. Member for Twickenham. While we do not believe it is the right approach to set additional reporting mechanisms in legislation over and above the different reports that NHS England and the Secretary of State already make to Parliament, which offer opportunities for debate, we are happy to consider whether, within the existing reporting mechanisms, there is a way to better convey to the House and the public more widely the progress we are making against those targets.
The NHS long-term plan represents the largest expansion of mental health services in a generation, renewing our commitment to increase investment faster than the overall NHS budget in each of the next five years. Not only will spending on mental health services increase faster than the overall NHS budget as a proportion, but spending on CAMHS will increase at an even faster rate. The hon. Member for Twickenham was right to highlight the importance of CAMHS. In our surgeries, we have all had constituents come to see us who are deeply worried and concerned about the mental health and welfare of their children, be that in relation to eating disorders, which I focused on when I came to this place, or a range of other factors. We are committed to delivering the NHS long-term plan to transform children and young people’s mental health services, with an additional 345,000 children and young people being able to access those services.
While we are deeply sympathetic to the spirit behind the amendments on mental health spending, we do not believe that putting a ring fence into the Bill is the appropriate way forward, given the work already being done, the money already being spent and the outcomes already being delivered. We believe that the reporting requirements are already extensive and varied. They already give the public and Parliament the opportunity to scrutinise the work of the Department and NHS England. We are happy to look at ways in which those reports might be more accessible and include different metrics, but we believe it would be wrong to legislate on them at this point.
As I said on Second Reading, this is a simple Bill. It has two clauses, of which one is substantive. It has a single, simple aim: to enshrine the funding settlement behind the NHS long-term plan in law. It delivers the funding that the NHS said it needed and wanted, and it delivers on this Government’s pledge to do so within three months of the election. In the light of that, while the amendments are clearly well intentioned and we appreciate the spirit behind them, they are unnecessary additions to the Bill, and I urge their proposers not to press them to a vote. I appreciate that Members have indicated their intention to press some amendments to a vote, I urge them, in the short period remaining before Committee ends, to reflect a little longer on whether they might reconsider and not move their amendments to a vote.
Three hours having elapsed since the commencement of proceedings, the debate was interrupted (Programme Order, 27 January).

Eleanor Laing: Under the programme order of 27 January, I must now put the Questions necessary to dispose of the  proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill, and on the consideration —Report—stage and the consent motion in the Legislative Grand Committee (England). I can see some puzzled faces around the Chamber, and not only among those who have newly been elected to this place, so for the sake of Members unfamiliar with our procedures in respect of Legislative Grand Committees, I will set out what is about to happen.
I will put the Question on amendment 2, which has already been proposed from the Chair. I will then call a member of the Legislative Grand Committee (England) to move amendment 3 to clause 1. When he has done so, I will put the Question on that amendment. I will then put the single Question that clause 1—or clause 1, as amended, if it has been so amended—and clause 2 stand part of the Bill. I will then call a member of the Legislative Grand Committee (England) to move new clause 4. When he has done so, I will put the Question that the new clause be added to the Bill.

Pete Wishart: Can you read it again?

Eleanor Laing: I could, but we might get to the stage where there are no votes at all.
When the proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill are concluded, I will resume the Speaker’s Chair for the Whip to report the Bill from Committee. As the three-hour knife has now fallen, there are no amendments for consideration on Report, as the hon. Member for Glasgow North (Patrick Grady) rightly pointed out in his point of order earlier.
The House will again resolve itself into the Legislative Grand Committee (England) to give consent to the Bill as a whole. I will call the Minister to move the consent motion formally, and I will put the Question on the consent motion forthwith. I can see that everybody understands this a lot better now. When the proceedings in the Legislative Grand Committee (England) on the consent motion are concluded, I will resume the Speaker’s Chair and call the Minister to move the Third Reading of the Bill.
I remind hon. Members that, if there is a Division in the Legislative Grand Committee, only Members representing constituencies in England may vote. All Members may vote on the Third Reading of the Bill.

Pete Wishart: On a point of order, Dame Eleanor. I am very sorry, but although I was listening very carefully, I did not quite catch all of that. Do you mind repeating it once again, please?

Eleanor Laing: I fully appreciate that the hon. Gentleman may not have caught all of that, but I happen to know that he is one of a handful of people in this House who does actually understand this procedure. I hope that I am one of the others, and everyone else will pick it up as we go along.
The Chair put forthwith the Question already proposed from the Chair (Standing Order No. 83D), That amendment 2 be made.
The Committee having proceeded to a Division.

Eleanor Laing: Will the Serjeant at Arms please investigate the delay in the Aye Lobby?

The Committee having divided: Ayes 163, Noes 300.
Question accordingly negatived.

Patrick Grady: On a point of order, Dame Eleanor. I think that we should mark this moment. This is the busiest that the English Parliament has been since 1707. I have never seen so many people so keen to take part.
I am interested in the numbers that have just been read out, Madam Deputy Speaker, because 163 for the Ayes seems very low to me. Just by means of a headcount, I counted a significant number more than that. In fact, according to my calculations, at least 46 Members from Scotland, Wales and Northern Ireland were in the Lobby just now. Can you tell me whether the number that was read out in the House accurately records the number of Members of Parliament who wished to express their view on the amendment?

Eleanor Laing: I am grateful to the hon. Gentleman for expressing his concerns in such an articulate fashion, and I note the words that he has used. I can confirm to him that, although his count of the number of Members who wished to express their view might well be correct, the numbers that I have announced to the House and on which I will rely from the Chair constitute the number of Members who have a right to vote on this matter. As the hon. Gentleman knows, under the procedures set out in Standing Order 83W—with which he, if not the rest of the House, must of course be familiar—Members who do not represent constituencies geographically situated in England do not have a right to vote in these particular Divisions.

Ian Blackford: On a point of order, Dame Eleanor. Perhaps you can enlighten me. Is this indeed the first time that Members from Scotland have had their votes discounted in this place? What conclusion should we draw, Madam Deputy Speaker, when an item such as this Bill will have spending  consequences for Scotland, and yet Scottish MPs are locked out of this place? Can we not draw our own conclusion that this is indeed the English Parliament? The answer to the people of Scotland is very clear: if you want your votes to be counted, we had better become an independent Parliament in Scotland.

Eleanor Laing: I am afraid that the right hon. Gentleman does not quite explain the situation as it really is. You see, this Parliament, as the Parliament of the United Kingdom, passed certain rules some time ago, and it is not correct to say that Members from Scottish constituencies are locked out; far from it. Members from Scottish constituencies, and constituencies in every part of the United Kingdom, have not been locked out. They have been allowed to participate in the debate, but not to vote in it. Members from Northern Ireland constituencies and from Welsh constituencies are similarly categorised for the purpose of these particular Divisions.

Michael Gove: Further to that point of order, Dame Eleanor. Is it not the case that health is a devolved matter, and that the NHS in Scotland is the responsibility of the Scottish Parliament? Is it not the case that, therefore, Members of this House have no votes on, or say in, what happens in the NHS in Scotland, and is it not appropriate to point out to SNP Members that while they stage these stunts here, the Royal Hospital for Sick Children in Edinburgh, for which they are responsible, remains closed, and cases of poisoning in hospitals in Glasgow for which they are responsible remain undealt with? Until the Scottish Government make sure that the health of the people of Scotland is looked after, the people of Scotland will regard this as a transparent stunt on the part of people who, instead of representing their constituents, seek to manufacture grievance.

Eleanor Laing: I fully appreciate the point—[Interruption.] Order. This will not degenerate into a shouting match.
The right hon. Gentleman has expressed his view with his usual rhetorical flourish. My only comment must be that this is a very narrow Bill, specifically making provision for the funding of the health service in England. I have to go with what it says on the Bill, and it is therefore correct for it to be administered in this way.

Martin Docherty: On a point of order, Dame Eleanor. I have due regard for your judgments. When I first rose to speak in the House in 2015, I said to the then Speaker that, while I was no Unionist or home ruler, I would stand shoulder to shoulder in defending the role of the Speaker. My concern, if this is the Parliament of the United Kingdom of Great Britain and Northern Ireland, is that this Bill has Barnett consequentials for the nation of Scotland, the nation of Wales and the communities of Northern Ireland. Therefore, I am gravely concerned that the EVEL system is being used to exclude the notion that there are Barnett consequentials. You may wish to clarify this for the Members of the Conservative and Unionist one nation party.

Eleanor Laing: I fully appreciate the point that the hon. Gentleman raises, and there may well be Barnett consequentials—[Hon. Members: “Ah!”] There may be  further opportunities when further legislation about these matters comes before the House, but this particular Bill is a very narrow one, and therefore the ruling is quite clear. I appreciate what the hon. Gentleman says about protecting the Chair and rulings from the Chair. In this case, there is no grey area. Under Standing Order No. 83W, no matter who passes through the Division Lobby in these three Divisions before us—or however many Divisions there might be—only the votes of Members sitting for English constituencies will be counted.

Maria Miller: On a point of order, Dame Eleanor. I know that Mr Speaker has strict rules about the use of promotional material in the Chamber of the House of Commons, and I am sure that, quite unintentionally, some Members might be displaying material that perhaps would be inappropriate. Will you point out that there are strict rules on that, and that it should not be done in the way that it has been done?

Eleanor Laing: I am grateful to the right hon. Lady. I must say to her and to the Committee that I was hoping that I would not see any promotional materials—[Interruption.] Oh no! I see one! I was hoping that such an occurrence would not happen right now. No promotional materials should ever be displayed in the Chamber. For the avoidance of doubt, I refer hon. Members to paragraph 21.29 of “Erskine May”—Mr Blackford, you will like this one—which states clearly that
“all Members should be sufficiently articulate to express what they want to say without diagrams”.
I will now proceed to amendment 3 to clause 1, which I have selected for a separate decision.
The Chair then put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83D).
Amendment proposed: 3, in clause 1, page 1, line 18, at end insert—
“and that the sums set out in the table are not permitted to be augmented by or composed of any virements from NHS capital budgets.”—(Justin Madders.)
The amendment would stop the Secretary of State meeting the NHS England allotment for resource spending by using funds from NHS capital budgets.
The Committee proceeded to a Division.

Eleanor Laing: I ask the Serjeant at Arms to investigate the delay in the Aye Lobby.

The Committee having divided: Ayes 161, Noes 298.
Question accordingly negatived.
New clauses 1 and 2 added to the Bill.

New Clause 4

Annual statement on performance

The Secretary of State must make a statement to the House of Commons no later than 31 March each year setting out—
(a) whether in the Secretary of State’s opinion the amount specified in section 1(1) for the following financial year is sufficient to meet the performance targets set out in the NHS constitution, and
(b) if in the Secretary of State’s opinion the amount specified in section 1(1) for the following financial year is not sufficient to meet the performance targets set out in the NHS constitution, what steps Secretary of State is taking to ensure that those targets are met.”—(Justin Madders.)
This new clause would require the Secretary of State to report annually on whether the allotment to the health service specified in section 1(1) year is sufficient to meet the performance targets set out in the NHS Constitution and, if not, what steps Secretary of State is taking to ensure that those targets are met.
Brought up.
Question put, That the clause be added to the Bill.

The Committee divided: Ayes 162, Noes 298.
Question accordingly negatived.
The Deputy Speaker resumed the Chair.
Bill reported, without amendment (Standing Order No. 83D(6)).
Bill, not amended in the Legislative Grand Committee (England), considered.

Eleanor Laing: There are no amendments on consideration.

Patrick Grady: On a point of order, Madam Deputy Speaker. It is great to be back in the United Kingdom Parliament—just like magic! I congratulate you on your skilful chairing of the English Parliament from the lower Chair over the last three hours. You have just announced that there are no amendments to be considered on Report as none had been tabled because the knife fell more than an hour ago. Could you confirm that that is correct? I notice that the selection list says:
“Mr Speaker has provisionally selected…New Clauses…as long as the 3 hour time limit has not expired: NC6 [SNP] + NC7 [SNP].”
For the record, can we confirm that the effect of all this has been that amendments tabled by Members of the Scottish National party have not been debated tonight and could not been divided on because the Government did not provide enough time, or Members took up so much time in the meeting of the English Parliament—the Legislative Grand Committee—that they have effectively denied the rights of SNP Members to table amendments to a Bill that directly affects our constituents?

Eleanor Laing: The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.
As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.
Does the Minister intend to move a consent motion in the Legislative Grand Committee?

Edward Argar: indicated assent.
The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).
[Dame Eleanor Laing in the Chair]

Eleanor Laing: I remind hon. Members, although I do not think there is any need for reminding at this stage, that if there is a Division, only Members representing constituencies in England may vote.

Patrick Grady: On a point of order, Dame Eleanor. We are back in the English Parliament again and the absurdity of this procedure is now being laid bare. [Interruption.] I am delighted that Conservative Members are groaning because several of them voted for it when it was introduced way back in 2015. They did not have to—it was a choice. I am not trying to beat the record of my hon. Friend the Member for Perth and North Perthshire (Pete Wishart), who has spoken in the Legislative Grand Committee for England more times than any other Member of this House over the past four years, but can we just confirm again that, as you said, if Scottish Members,  for whatever reason, were to object to the consent motion, you would not even be able to hear their voices —it is as if we are invisible?

Eleanor Laing: It is not as if any hon. Member of this House is ever invisible or, indeed, inaudible, but merely, once again, following Standing Order No. 83W, which this House resolved to put into the Standing Orders of the House.

Pete Wishart: On a point of order, Dame Eleanor. [Interruption.] I hear the groans from my Conservative colleagues. I have to keep my record of speaking in the English Parliament—it is a record that I very much cherish and look forward to maintaining. These events are being televised and people throughout the United Kingdom, particularly those in Scotland, are observing our proceedings with a degree of mystification and bewilderment. What Scottish viewers will see is the baying, groaning and booing of Conservative Members about Scottish Members of Parliament asserting their rights to have their say on the funding of the national health service. Can you confirm that that is the case and that this House really needs to grow up, behave itself and come into the 21st century?

Eleanor Laing: I understand the point that the hon. Gentleman makes. I would say, as Mr Speaker always says, and as every occupant of the Chair always says, that our behaviour in this Chamber should, at all times, be of a standard that makes us never ashamed to be watched by anyone on television or in any other way, regardless of the subject of our proceedings. I notice that that has engendered some slightly better behaviour—thank you.
Motion made, and Question put forthwith,
That the Legislative Grand Committee (England) consents to the NHS Funding Bill, not amended in the Legislative Grand Committee (England).— (Edward Argar.)
Under the terms of the Order of the House of 27 January, I must now put the Question necessary to bring to a conclusion the proceedings in the Legislative Grand Committee on the consent motion. The question is the consent motion. As many are of that opinion say “Aye”—[Hon. Members: “Aye!”]—of the contrary “No”—[Hon. Members: “No!”]. The Ayes have it—[Interruption.] We now come to a scientific matter. Members representing Scottish seats are well aware that they do not have the right to vote on this particular motion. They therefore do not have the right to shout “No” when I put the question. I can hear “Aye” from the Government Benches. The hon. Member for Perth and North Perthshire (Pete Wishart) knows that I am more than capable of discerning a Scottish “No” from a non-Scottish “No”—[Interruption.] Order. I am ruling that the shouting of “No” from the SNP Benches does not mean that we are going to have a Division.
Question agreed to.

Martin Docherty: On a point of order, Dame Eleanor. I always have due regard for you and anyone who sits in the Chair of any Parliament. You said that you could discern Scottish MPs shouting “No”; I fully understand that. Can you advise me whether you can hear Scottish constituency MPs on the Government Benches shouting “Aye”?

Eleanor Laing: I believe I can, but as their voices have been drowned out by the English “Ayes”, I cannot hear the Scottish Members on the Government Benches. [Interruption.] The hon. Member for Milton Keynes South (Iain Stewart) points out that, although he has a Scottish voice, he has an English vote. We have had enough of this.

Ian Blackford: On a point of order, Dame Eleanor. I am grateful to you for allowing this point of order. I wonder whether you can help me. When we were all elected to this place in December 2019, we were sent here to represent our constituents. What message does it give to the people of Ross, Skye and Lochaber and the constituents of my many hon. Friends that we are not permitted to vote on matters in this House that have direct consequences for spending in Scotland?

Eleanor Laing: That is not a point of order for the Chair, and my opinion on the matter is irrelevant. We have had enough points of order; it is time to continue with business.
The occupant of the Chair left the Chair to report the decision of the Committee (Standing Order No. 83M(6)).
The Deputy Speaker resumed the Chair; decision reported.
More than four hours having elapsed since the commencement of proceedings in the Legislative Grand Committee (England), the proceedings were interrupted (Programme Order, 27 January).
Question put forthwith (Standing Order No. 83E), That the Bill be now read the Third time.
Question agreed to.
Bill accordingly read the Third time, and passed.

Telecommunications Infrastructure (Leasehold Property) Bill (Programme) (No. 2)

Motion made, and Question put forthwith (Standing Order No. 83A(7)),
That the Order of 22 January 2020 (Telecommunications Infrastructure (Leasehold Property) Bill: Programme) be varied as follows:
In paragraph (2) of the Order (conclusion of proceedings in Public Bill Committee), for “6 February” substitute “13 February”.—(Iain Stewart.)
Question agreed to.

Rating and Valuation

Jesse Norman: I beg to move,
That the Local Government Finance Act 1988 (Non-Domestic Rating Multipliers) (England) Order 2019, which was laid before this House on 4 November 2019, in the last Session of Parliament, be approved.
This order makes a small but important technical change to business rates. Specifically, it changes the annual inflationary increase in the business rates multiplier from the retail prices index to the lower consumer prices index for the coming financial year. As hon. Members may know, the multiplier is effectively the tax rate applied to the calculation of business rates, be it through the standard multiplier or the small business multiplier. Historically, these multipliers would rise in line with the preceding year’s RPI figure. On this basis, the multipliers were due to increase to reflect the September 2019 RPI figure, which was 2.4%. In Budget 2016, the Government announced that they would switch the multiplier uprating from RPI to CPI indexation from April 2020. [Interruption.]

Rosie Winterton: Order. Will Members leaving the Chamber do so quietly, please?

Jesse Norman: The autumn Budget 2017 brought forward this implementation date to April 2018. The switch makes a reduction to business rates that is estimated to be worth more than £6 billion over the next five years, and the benefit to business will continue to grow as the business rates multipliers are uprated by the lower rate of inflation year on year. The Government introduced regulations to make this change for previous years, and we are bringing forward this order to do the same for 2020-21.
Before I proceed to outline the detail of the order itself, I would like to set out some of the background for the benefit of the House. The Government recognise that business rates can represent a high fixed cost for some businesses—indeed, many businesses—and we have taken repeated steps to reduce the burden of the tax. Reforms since Budget 2016 include, first, making 100% small business rate relief permanent and doubling the threshold of this relief from April 2017. As a result, more than 675,000 of the smallest businesses do not pay business rates at all. Secondly, increasing the threshold for the standard multiplier to £51,000 from April 2017 has removed many properties from the higher rate of the tax. Thirdly, moving to more frequent valuations by bringing the next revaluation forward one year to 2021 and moving to three-year revaluations after that will make bills fairer by ensuring they more closely reflect properties’ current rental values.
Finally, introducing a new retail discount has cut the business rates bills of small retailers by one third for two years from April 2019. This is providing up-front support to the retail sector at what is proving to be a challenging time for many retailers, and it is worth about £1 billion to businesses.
Looking forward, as confirmed in the statement I made on 27 January, from 1 April this year the Government will increase the retail discount to 50% in 2020-21, and extend eligibility to independent cinemas and grassroots music venues for the first time. We will provide additional  support to pubs through a £1,000 discount for pubs with a rateable value of less than £100,000. We will extend the duration of the £1,500 discount for local newspaper office space for a further five years. However, it is important to be clear that the Government recognise that concerns remain about the impact of the tax. That is why we are committed to a further review of business rates, details of which will be announced in due course.
The order before the House is the necessary secondary legislation required to effect the change in the inflationary increase for business rates from RPI to CPI in the financial year 2020-21. It sets out the new equation for setting the business rates multipliers for the coming financial year, so that the September 1.7% CPI figure is used instead of the 2.4% RPI figure.
Given the difference in the multiplier from uprating this year, the small business multiplier in 2020-21 will be 49.9p, rather than 50.3p. The standard multiplier in 2020-21 will be 51.2p, rather than 51.6p. That change represents a cut in business rates every year, benefiting all rate payers and freeing up cash for businesses. The order applies to England—unlike in the last debate, Madam Deputy Speaker, there has not been quite the same interest from Scottish nationalists about this measure, although both provisions apply to England. The Government will provide the devolved Administrations with funding to enable them to offer similar support if they wish, and they will fully compensate local authorities for the income they will lose as a result of this measure.
This measure should not be viewed in isolation, and as I have said, it is one of many introduced by this Government, and their predecessor Governments, to support business. I have mentioned numerous cuts to business rates, including the two-year business rates relief for small retailers. Looking more widely, the UK corporate tax regime remains highly competitive, with the Government having lowered corporation tax from 28% in 2010 to 19% today—the lowest rate in the G20. Beyond that, businesses are benefiting from enhanced tax incentives, including the introduction of the new 2% structures and buildings allowance, and a temporary increase in the annual investment allowance to £1 million.
The statutory instrument that we are legislating for today will contribute to the Government’s efforts to reduce the burden of business rates and make them fairer for taxpayers. As I outlined, on top of the reliefs already in place, the Government are committed to a review of the business rates system, details of which will be announced in due course. In conclusion, this order will change the annual inflationary increase in business rates from the retail price index to the consumer prices index in financial year 2020-21, thereby reducing costs for all business rate payers in England and giving the economy a further boost. I commend the order to the House.

Anneliese Dodds: I am grateful to the Minister for his explanation of the order, and broadly supportive of its contents. It does, however, raise some significant questions about the Government’s continued use of the retail price index as against the consumer prices index, and about their approach to business rate reform and local government funding more widely.
Members will be aware that there has been continued argument about the use of RPI as an inflation indicator, as against CPI and CPIH. RPI was de-designated as a national statistic back in 2013, yet it is still often used in areas such as the regulation of train fares, student loan debt, and many occupational pension schemes. CPI has been adopted in this case, but we have no clear explanation why the use of RPI continues in other areas. The Royal Statistical Society has been highly critical of that approach.
After many years of confusion, the Chancellor has now agreed not to cease the production of RPI statistics, but to slowly align them with CPIH, thus ending the situation of, as The Financial Times put it,
“the Office for National Statistics and UK Statistics Authority publishing a key economy measure every month which they accept is wrong, but doing nothing to improve it.”
That is what has been happening over the past few years. I therefore find it quite revealing that, rather than amending the Local Government Finance Act 1988 through primary legislation to make that change permanent, the Government choose to make it yet again, year on year, through secondary legislation. Is this use of orders, rather than primary legislation to designate the relevant inflation measure, to retain flexibility for the Government, or for some other unexplained reason? Either way, it creates a potentially unstable environment for businesses and local authorities, perhaps up to 2025 or beyond.
We have seen no uprating in the existing thresholds at which discounts on business rates apply. I accept that the retail discount has increased from one third to 50%, and been extended to some additional categories of economic operator. I am probing, through parliamentary questions, what proportion of rateable businesses are actually covered, given the low thresholds at which those discounts apply, especially in areas of high property costs.
The Conservative manifesto said that the Government would go further and fundamentally review the business rate system, so it was disappointing that the Minister said—twice—that this would happen “in due course”. Will he please tell us once when that review will at least begin, and what its scope will be? According to the British Retail Consortium, 2019 was the worst year for retail in 25 years. We need some urgency from the Government in dealing with this issue. We also need to deal with the impact of the business rate system on preventing the investment that is required to ensure environmentally friendly business and manufacturing.
Finally, we need to put rating in the context of the overall local government funding settlement. It was disappointing that the Minister did not talk about that at all, but merely about compensation for this measure in the settlement. All Labour Members realise that the Government are suggesting a real-terms cut to local government. Even worse, the alleged increase they are putting into local government is predicated on all councils increasing council tax by the full amount, which they blatantly will not do—smoke and mirrors yet again. We have seen a concerning trend where funding from local authorities in less affluent areas is stripped back at a far faster rate than it is in more affluent areas. The Government’s laughably named fair funding approach would see almost three-quarters of the so-called red wall seats losing out even further. There is great concern among those in local government that reforms to business rates could make this even worse, with 77% of councils saying that they lack confidence in 100% business rate retention.
I hope the Minister will address these concerns, outline a timetable for the review of business rates, indicate whether that review will include considerations of local government, and, above all, let us know whether we will see an end to the current uncertainties around CPI adoption.

Rosie Winterton: It is with great pleasure that I call Paula Barker to make her maiden speech.

Paula Barker: Thank you, Madam Deputy Speaker, for giving me the opportunity to make my maiden speech in this place. I congratulate you on your election and wish you the very best for the future.
I want to take a brief moment, at the beginning of this speech, to pay tribute to my predecessor, Luciana Berger, who served my constituency for nine years. In particular, her commitment to raising the profile of mental health issues was very encouraging. Although it is an issue more widely talked about than ever in society, it sits far too low down on the political agenda. I wish Luciana and her young family the very best for the future.
My wedding day was the best day of my life and my two sons are my proudest achievement in life, but it is the greatest honour of my life—and a most humbling one—to sit in this Chamber as the Labour Member of Parliament for Liverpool, Wavertree. I represent a wonderfully diverse constituency in south Liverpool. It has a number of communities—from Childwall to Church, from Kensington to Old Swan, from Picton to Wavertree itself—unique with their own characteristics, rich in their own history and proud of their contribution to our city’s story. I will speak for all our people in all their diversity, not least for some of the longest-established minority communities in our nation. Our Yemeni community, our Jewish and Hindu communities, and our Afro-Caribbean and African communities. I cannot go on without mentioning how much it means to our city to finally have a black MP from Liverpool sitting on these Benches—my good friend, my hon. Friend the Member for Liverpool, Riverside (Kim Johnson).
My constituency is economically diverse, too, and that is something I am less inclined to celebrate. Liverpool, Wavertree is the story of two constituencies. The economic disparity between the wealthiest and poorest parts of my constituency is far too great. My socialism is aspirational: it is not about levelling down, but rather levelling up communities that for far too long have suffered at the hands of crushing Tory austerity.
I was born in the constituency at Sefton General Hospital. My mother and father both worked at the sweet factory, Barker and Dobson—the name a mere coincidence. Both were workers on the shop floor and members of the Transport and General Workers Union. When my dad tragically died two weeks before my second birthday, my mum raised me as a single mother—so, according to the Prime Minister, in his own words that makes me “ill-raised, ignorant” and “aggressive”. In all honesty, I may well be the latter—it comes with the territory of being a woman with an opinion, and a Scouse one at that.
I joined my trade union, Unison—or NALGO, as it was then—on my first day working for Liverpool City Council, so it is apt that we are discussing a statutory  instrument on local government finance today. Liverpool City Council is a council that has had its funding reduced by 64% since 2010, equating to £640 million; a council that is the backbone of our communities, providing services from cradle to grave; and a council that, along with so many others, needs to be funded properly and equitably.
I did not find politics; politics found me. I owe most things in life—I make no apology for this—to the trade union movement. It was that movement that gave me security at work. It was that movement that made me understand the power of solidarity. And it was the working-class movement that made me realise that we, the collective, are the tide that lifts all boats. All these principles were reaffirmed—and thank you to Conservative Members—by the Conservative party, which waged an unrelenting assault on my city, attempting to put us into a state of “managed decline”.
We are self-reliant, hard-working and independently minded people. There is no such inclination towards “welfarism” or a prevailing sense of “victimhood”, as The Spectator once asserted while the Prime Minister was undertaking tough, arduous graft doing real work in that infamous sweatshop that was its editorial room. Like my party, we are a city of work and workers—human beings with long memories, united in our ideals and fundamentally optimistic about our collective future. I will always champion my constituency, my city, wider Merseyside and our beloved north-west region, so long as the good people of Wavertree continue to put their faith in me.
I want to give a warning to Conservative Members using a contemporary example, but before I do, I must say that the Secretary of State for Housing, Communities and Local Government is not better qualified to understand the problems that our city faces than the actual people who represent it. The point is this: if devolution is to mean anything whatsoever, it is Liverpool City Council and the city Mayor who should have the power to decide whether to continue the successful landlord licensing scheme. I know that my constituents will suffer on the back of the decision to withdraw the scheme, and we will not take it lying down. We seldom take anything lying down in my part of the world.
Bill Shankly had it right when he said:
“The socialism I believe in is everyone working for each other, everyone having a share of the rewards.”
It is the way he saw football and life. I and my fellow Scousers are not much different. My party has a long road back to power. United in our common aims and values, we can and will overcome the odds to achieve power, because it is only through power that my constituents will be able to realise their hopes, dreams and aspirations.

Jesse Norman: Let me start by responding to the comments from the Opposition Front Bencher, the hon. Member for Oxford East (Anneliese Dodds), who raised a series of questions of a technical nature. She asked why the Government are continuing to use RPI versus CPI, and I was grateful that she acknowledged that the policy has been one of slow alignment. In September 2019, the Chancellor announced that the Government and the UK Statistics Authority would jointly consult on proposals to address shortcomings in RPI. We expect that consultation to launch at the time of the Budget.
I am sure the shadow Minister is aware—I think she hinted at this—that since 2010 the Government have been reducing the use of RPI, and we will continue to do so where practicable. She asked why primary legislation had not been used in the context of this instrument. The answer is that the Government have made a commitment that this will be permanent and that they will use CPI for the uprating of business rates. We have also said—if we have not, let me say it now—that we will consider introducing primary legislation in due course, but the parliamentary timetable is very congested and we have to make sure it can fit alongside many other items, including items to which I am sure she is thoroughly committed.
The shadow Minister talked about raising thresholds. As I think she will acknowledge, we have increased the rate for the retail discount, and the pubs discount has been set at a high level and so includes a great number of pubs. She asked about the review. We have said we will launch a review in due course. I will not go further than that, although at this time of the year it does not require the application of rocket science to see when “in due course” might ultimately land.
Finally, the shadow Minister talked about local government. Of course, she is right to focus on the importance of business rates to local government funding. I had the British Retail Consortium in to see me only recently, and I talk closely with all those affected by the rate. As she will be aware, the Secretary of State for Housing, Communities and Local Government published the provisional 2020-21 local government finance settlement in December, which set out an additional £2.9 billion in core funding, as announced in the spending review 2019. As she also knows, however, it is not just a matter of what funding is provided by central Government; it is also a matter of what core spending power is available to local authorities.
I am pleased to welcome the hon. Member for Liverpool, Wavertree (Paula Barker), who made her maiden speech. I congratulate her and welcome her to her place in the House. She got wonderful support from her colleagues on the Opposition Benches, which is always a comfort when doing one’s maiden speech, so I congratulate her on that as well. She described herself as a woman with an opinion. In this House, anyone who can describe themselves like that will go a long way, so I congratulate her again. Just to correct the public record, however, I hope she will recognise that Tory support for Liverpool goes back a long way. Michael Heseltine was recently given the freedom of the city in recognition of his support, and I think that everyone can see the difference and the energy the city has at the moment. The Government are seeking to support it and the mayoralty in many different ways.
Question put and agreed to.

Rachael Maskell: On a point of order, Madam Deputy Speaker. I wonder if you could assist me. When we have a public health scare, we expect the Government to be in control. Yesterday, I raised the serious issue of how information about the coronavirus infection was being shared and how getting communications right was crucial to alleviating public concern while also protecting the public. Today  we have learnt that the information provided concerning those infected with coronavirus was incorrect. The student did access student accommodation—Vita Student accommodation—despite our being told they had not. There is confusion over how information is being gathered and shared, which could have a serious impact on public confidence in how the coronavirus is being managed. The Government need to get a grip as we may be in the early stages of the management of this infection. Could you, Madam Deputy Speaker, advise the House on whether the Secretary of State for Health and Social Care intends to make a further statement to the House, in particular to address the management of communications surrounding coronavirus, in the light of the latest developments?

Rosie Winterton: I thank the hon. Lady for her point of order, and for giving me notice of it. Obviously the Secretary of State is responsible for the accuracy of what he says in the Chamber, and for the information that is given to the public about this extremely important matter. I have not heard of any intention on the part of Ministers to make a further statement, but those on the Treasury Bench will have heard the hon. Lady’s point of order, and I know that she is well aware of the further routes that she can pursue if she remains dissatisfied with the situation.

Business without Debate

Delegated Legislation

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Electricity

That the draft Electricity Supplier Obligations (Excluded Electricity) (Amendment) Regulations 2019, which were laid before this House on 9 September 2019, in the last Parliament, be approved.—(Iain Stewart.)
Question agreed to.
Motion made, and Question put forthwith (Standing Order No. 118(6)),

Public Bodies

That the draft Public Bodies (Abolition of Public Works Loan Commissioners) Order 2019, which was laid before this House on 14 October 2019, in the last Session of Parliament, be approved.—(Iain Stewart.)
Question agreed to.

Business of the House (11 and 12 February)

Ordered,
That,
(1) at the sitting on Tuesday 11 February, notwithstanding paragraph (2)(c)(i) of Standing Order No. 14 (Arrangement of public business), business in the name of Ian Blackford may be entered upon at any hour and may be proceeded with, though opposed, for three hours; proceedings shall then lapse if not previously disposed of; and Standing Order No. 41A (Deferred divisions) shall not apply;
(2) at the sitting on Wednesday 12 February, notwithstanding the provisions of Standing Order No. 16 (Proceedings under an Act or on European Union documents), the Speaker shall put the Questions necessary to dispose of proceedings on—
(a) the Motion in the name of Secretary Priti Patel relating to Police Grant Report not later than three hours after the commencement of proceedings on that Motion, and
(b) the Motions in the name of Secretary Robert Jenrick relating to Local Government Finance not later than three hours after the commencement of proceedings on the first such Motion or six hours after the commencement of proceedings relating to Police Grant Report, whichever is the later; proceedings on those Motions may continue, though opposed, after the moment of interruption; and Standing Order No. 41A (Deferred divisions) shall not apply.—(Iain Stewart.)

Petition - Minerals Quarry in Barford, Warwickshire

Matt Western: I am pleased to present a petition on behalf of my constituents who oppose the establishment of quarries in the immediate vicinity of our communities. Quarrying generates considerable dust, especially silica particulates. The people of Barford, whom I support, have begun a national campaign to stop such quarries, which started with the recognition of the huge risk to health that those such as the one proposed at nearby Wasperton present to human health. The petition reads as follows:
The petition of residents of the constituency of Warwick and Leamington,
Declares that Warwickshire County Council’s plans for a minerals quarry in Wasperton, near the village of Barford, should be withdrawn.
The petitioners therefore request that the House of Commons urges the Government to ensure that Warwickshire County Council’s plans for a minerals quarry in Wasperton, near the village of Barford, should be withdrawn.
And the petitioners remain, etc.
[P002554]

Rail Services: North-East England

Motion made, and Question proposed, That this House do now adjourn.—(Iain Stewart.)

Kevan Jones: I am very pleased to have secured the debate, but it is sad that it also gives me another opportunity to raise the poor service that constituents of mine who travel from Chester-le-Street railway station are still receiving. I initiated a similar debate on 15 January 2019, highlighting the poor service that was being generated from the change in the timetables in May 2018. The Minister who replied was the then Parliamentary Under-Secretary of State for Transport, the hon. Member for Harrogate and Knaresborough (Andrew Jones), and I think it is worth reiterating what he said. He said:
“There will be no repeat of the processes that led to the failure of May 2018 and that timetable change.”—[Official Report, 15 January 2019; Vol. 652, c. 1139.]
He also said that he entirely agreed with me that services offered to several parts of the country, including the north-east, had been “unacceptable”. Then, trying to strike a bright note and thinking that it was a positive gesture, he said that new rolling stock which would be brought into service in the coming months should make life easier for passengers using Chester-le-Street railway station.
All I can say is that nothing could be further from the truth. We have now experienced the impact of the new timetable that was introduced in December 2019. Given the combination of shocking incompetence on the part of those responsible for the timetable and the blatant disregard of operators—mainly TransPennine Express—for the wishes of the travelling public, the situation is just as bad, and not just in my constituency: I know that it has been affecting others across the north-east.

Mike Hill: Hartlepool is the third busiest train station in the north-east, which shows that there is great demand for rail travel, yet the trains to Newcastle run only once an hour, and even then they have only two carriages. Does my hon. Friend agree that that is completely unacceptable and that more resources should be put into stations that are well used, such as Hartlepool?

Kevan Jones: I totally agree; it is the same story that we get all the time. If Hartlepool, a town adjacent to the two major conurbations of Teesside and Tyneside, were in the south-east of England, it would have a service every half hour, rather than the one my hon. Friend has just outlined.
That brings me to the changes that were brought in in 2019. The timetable for my constituents got off to a flying start, because the two peak-time commuter trains, at 7.10 and 8.03 in the morning, were both cancelled on the first day. A further 11 daily TransPennine services to the north-east were withdrawn by the end of January, which left only 50% of TransPennine’s timetable for the north-east operational. TransPennine had given clear commitments to Transport for the North that there would be a seamless integration of the new timetable.

Jim Shannon: The hon. Member is right to bring this issue forward, and he is always very assiduous for his constituency. Does he not agree that in  order to have a thriving industry and business district, there must be a reliable, dedicated public transport service? Does he also agree that that takes funding and a forward-thinking strategy, and that more of both must go into the rail network in his area and into public transport in general throughout the United Kingdom?

Kevan Jones: I agree with the hon. Member. Chester-le-Street in my constituency is a commuter town for Teesside and Tyneside, and it relies on good public transport.
The timetable got worse, and by January it had still not been fixed. Between 1 January 2020 and 24 January 2020, 17 TransPennine services were out of action. The managing director of TransPennine said that performance was “not up to scratch”, but I think some of my constituents would use more forceful language to describe it. The Department for Transport said that it was “completely unacceptable”, which again is a bit of an understatement.

Grahame Morris: I congratulate my hon. Friend on securing this important debate. He is absolutely correct. It is not just in North Durham but in my constituency that the services are a disgrace. The trains are often filthy and they often have only two carriages so people cannot get on to them. We were promised that the ancient Pacer trains would be replaced by Sprinter trains, but they are actually trains of the same age. How can we address the problem of the regional disparities and level up on transport infrastructure investment in rail services, given the terrible state of the services and the terrible record that we have to cope with at the moment?

Kevan Jones: My hon. Friend makes a good point. We have seen a lot of promises recently about investment in transport infrastructure in the north, but there is a combination of two things here. It is about cash, but it is also about competence in running the network. Before we start opening up new lines, we need to ensure that the existing ones work properly. The franchising system in this country has clearly failed. His constituency, like mine, is next to two large conurbations, Tyneside and Teesside, and his constituents should be able to travel there easily. Again, if it was in the south-east of England, they would be able to do so.

Kevin Hollinrake: I thank the hon. Member for securing this important debate. I agree that the TransPennine service has been dire. It was already the second-worst performing franchise in the country, but in December it got much worse. Only half the trains were on time, and 33% were either significantly late or cancelled. Does he agree that there should be a more punitive system of fines to focus the attention of the management and to ensure that these services run on time?

Kevan Jones: I will come on to my response to TransPennine, but the underlying problem is how the timetable was drawn up. Durham County Council clearly indicated what it wanted to see at Chester-le-Street, a growing commuter town, only to find that services were taken away. When I wrote to the Transport Minister, I received a letter saying, “Well, you’ve got more stopping services.” We have, but not at the times when people actually want  to travel. For example, the popular 7.17 am train was taken off the timetable and the equally popular 5.15 pm train southbound from Newcastle was moved over half an hour later. It is no good arguing that more trains will be stopping if they stop at times when people do not want to travel. It is a fundamental flaw. Frankly, Transport for the North should be renamed “Transport for Leeds, Sheffield, Manchester and Liverpool” because it clearly does not seriously consider representations from anywhere north of York.
The ongoing effects have had an economic impact, as the hon. Member for Strangford (Jim Shannon) mentioned. This is not just about the frustration of individuals who find that trains have been cancelled, because there is an equal economic impact. As I said in my previous debate, people have had to give up jobs or not accept promotions because they cannot get into work, and families who want to come back to look after their children find it difficult to do so. That is just not acceptable.
I would like Transport for the North to tell me about another town like Chester-le-Street, where 30,000 people live, that has such a poor service and is totally disregarded. The facts speak for themselves, because train usage at Chester-le-Street is actually declining—it dropped by more than 9% between 2017 and 2019—and my hon. Friend the Member for Easington (Grahame Morris) saw usage at Seaham drop by 2.5%. There is this great mantra that we should be getting people out of cars and on to public transport, but the mess with the operation of the timetable is driving people off the railways, and that cannot be good for congestion in Tyneside and Teesside.
Turning to the point raised by the hon. Member for Thirsk and Malton (Kevin Hollinrake), I have to say that TransPennine is appalling. I hate using the term, but it is not fit for purpose. It could not run the proverbial in a brewery if it was given the instructions. It does not care about passengers. There is no information when services are cancelled. People turn up and they are told the train is late, and then it is just cancelled, leaving people to their own devices. No information or alternative buses are provided. The situation is not down to any lack of trying, because I have raised the matter directly with TransPennine officials, including at a public meeting I held with them two years ago where they said they would provide information, but they just do not care. Their attitude stinks.
I thought April fools’ day had come early last week when TransPennine put out its stakeholder newsletter. I do not know whether any other colleagues received it, but it included a big photograph showing how proud it was to win rail operator of the year at the business travel awards. All I can say is that I would hate to see what the competition was if TransPennine won, and it is quite clear that the judges did not speak to many of my constituents or those of many colleagues. It was a further insult when TransPennine announced on social media that from this week, it is going to stop people buying tickets on its trains, saying that if people get on without a ticket, they will be fined.
Since the ticket office was closed, Chester-le-Street station only has ticket machines on the southbound platform, and they are often not working, but people getting on the train without a ticket will be fined.
In the last week, two constituents have complained to me that they have bought tickets on trains, but have been treated in a threatening manner and told that in  future they will be fined. I am sorry, but if the company cannot maintain a network and provide the service, it is an insult to my constituents, and other travellers, to make such threats. My constituents do not want threats. They want trains to turn up on time and, in some cases, to turn up at all.
The hon. Member for Thirsk and Malton asked what the answer is. I have to say that TransPennine needs the franchise taken away. Northern has had its franchise taken away in the last few weeks, and we need to follow. Ironically, at Chester-le-Street, the trains that turn up on time have actually been Northern, which I know is not the experience of other colleagues. If Northern has had the franchise removed, so should TransPennine. What will happen to the investment that Norther earmarked for improvements at Chester-le-Street station, because there is clearly some doubt about what will happen now? TransPennine has been given enough chances. As I said earlier, its attitude stinks. It is not customer-focused and it is having a detrimental effect on many of my constituents.
Finally, I want to raise a broader issue. I know that in the near future—perhaps this week—the Government will make a decision on HS2. Personally, I have never been a great fan. I do not think it will affect many of my constituents, apart from swallowing large amounts of public investment over the next decades, but there is an issue that the Government could address now. We have had various promises thrown around about opening the Beeching closure lines and others in the past few weeks, but if HS2 is to benefit the north-east—look past York, because there is more to the north than York and Leeds—what is needed is the upgrade of the east coast main line. Without that, HS2, when it finally does arrive—if it ever does—will not be able to increase capacity from the north of York to further north.

Mike Hill: I thank my hon. Friend for giving way again. First, I wish to correct the record as I ambitiously stated that Hartlepool was the third busiest station in the north-east: I meant on Teesside. Important to that is the condition and state of that line. The Durham coast line has needed an upgrade for years and years. Does he agree that that investment is absolutely necessary?

Kevan Jones: I do, and my fear about HS2 has always been that investment will be sucked out of the rest of the network. Although we have now got the magic money tree—if not an entire equatorial rain forest of money trees—from the Government for HS2, plus all the investment in lines such as my hon. Friend’s, we will have to wait and see what actually happens. It is important that if the north-east is to benefit from HS2, that investment is put into capacity in the east coast main line north of York. The Government could do that now, and it would have a beneficial effect for the travelling public by helping capacity, and that should be addressed if we do have the announcement on HS2.
My constituents are frankly fed up with the service that they have received from the rail services from Chester-le-Street. My broader concern is the one raised earlier about the economic impact on my constituents, because Chester-le-Street is a great place to live. People move there because it is a great place to bring up families, with good schools, but people need to be able to travel to jobs in the south of the region and in the  north of the region. Without a good rail service they cannot do that. What they want is not warm words or political promises of funding tomorrow: they want action now.

Chris Heaton-Harris: I thank the right hon. Member for North Durham (Mr Jones) for securing this debate on rail services in the north-east and I thank all Members who have contributed to what has been quite an informative debate.
I bumped into the right hon. Gentleman earlier today, and I looked up the report of his previous speech on this matter, on 15 January. I note that he has not really had to do much work to improve his words, because it is very similar to the speech that he unfortunately had to make a year ago.
A number of issues were raised, which I shall address. I would like to reassure the House that the Government’s priority is for the country’s trains to run on time, and to drive growth by giving local leaders a greater say in the running of their railway. As such, we are investing billions of pounds in the rail system, from which passengers can benefit. The right hon. Gentleman was slightly dismissive of that investment, but it is worthwhile investment in infrastructure and will level up the country.
I note that a number of other hon. Members intervened —the hon. Members for Hartlepool (Mike Hill), for Strangford (Jim Shannon), for Easington (Grahame Morris) and for Thirsk and Malton (Kevin Hollinrake). A couple of right hon. Gentlemen would have loved to intervene in the debate but could not—my right hon. Friend the Member for Scarborough and Whitby (Mr Goodwill) because he could not be here, and the right hon. Member for Newcastle upon Tyne East (Mr Brown) because he is the Opposition Chief Whip. I take the opportunity to record their concern about what has been going on with TransPennine Express services.
As the right hon. Member for North Durham said, my Department said recently that those services had been unacceptable, and we believe that is the case. In the December 2019 timetable change, TPE planned to increase the number of calls that it made at Chester-le-Street from 21 to 23 per day. That included a new southbound 7.52 am service to help passengers travelling at peak times to Durham, Darlington, York, Leeds, Manchester and Manchester Airport from his constituency. Unfortunately, following delays to the introduction of new rolling stock, a temporary timetable was put in place, which impacted TPE trains scheduled to call at Chester-le-Street. I have been advised that the full December timetable will be reinstated in the next few weeks.
Chester-le-Street is a station served by TransPennine Express services on the Manchester Airport-Newcastle route, and since 20 December 2019 TPE has extended the Liverpool-Newcastle service to and from Edinburgh. That service, when it functions properly, will provide Morpeth with an hourly service for much of the day to and from Edinburgh for the first time in years—something that has been welcomed, if it were only to be delivered on a regular basis.
TPE also provides a through morning service from Chester-le-Street to Edinburgh. During this month, TPE will have 13 of its Nova 1 trains in service to and from Newcastle, providing an inter-city level of comfort and  additional seating per train. Those trains will call at Chester-le-Street. As the right hon. Gentleman is aware, Chester-le-Street is on the east coast main line, which is a very busy line, thus limiting any extra services that TPE could possibly provide.
However, we all know of the issues that the service has had in the past couple of months. Issues with training drivers and getting the rolling stock in on time have led to all sorts of different issues—for example, with signalling.

Kevan Jones: I accept that there have been issues with it being a busy line, but the new timetable took out, for example, the 8.17 am northbound to Newcastle and the 5.20 pm southbound, both of which were very busy with commuters; the two most popular trains were taken out of the timetable. For what reason?

Chris Heaton-Harris: I guess that is a question for the franchise to answer for itself, but I completely understand the right hon. Gentleman’s frustration, and that of his constituents who would like to use a service to go to and from work at times when ordinary people would be commuting.

Grahame Morris: I know the Minister is in a terribly difficult position. I do not know whether the theme tune should be “Things can only get better”, but the theme of the Adjournment debate is rail services in the north-east. Northern provides a once-an-hour service for my constituents, whose only station is Seaham, and it consists of two carriages. My right hon. Friend the Member for North Durham (Mr Jones) shared some statistics that had been produced today, showing that passenger numbers are falling at Seaham station. The truth of the matter is that the trains are so packed people cannot get on at peak times, particularly at weekends. So, perversely, the figures are showing that rail usage is declining, whereas it would increase if we had more capacity.

Chris Heaton-Harris: “Things can only get better” is the most new Labour thing the hon. Gentleman has ever said, but I completely understand the point he is making. In fact, it is very Kevin Costner: if you build it, they will come. That is the case with the railways nowadays.
I was trying to talk about the problems that there have been with services. As right hon. and hon. Members in the Chamber well know, to try to correct problems with the service within timetable, TPE has been stopping services at York, meaning that lines further north to places such as Scarborough and Whitby, Thirsk and Malton and others have not been provided with the timetabled service that people would expect.
TPE is investing heavily in its rolling stock. As part of its £500 million investment in trains, it is currently introducing three new fleets into passenger service. Trains in all three fleets will be operating across the north and into Scotland by the end of this year, providing 13 million extra seats a year. We hope to be able to address some of the capacity problems that hon. Members have outlined, and TPE will have 44 brand new, state-of-the-art trains, with five carriages each, which will provide an opportunity for new routes and services, and increase capacity by more than 80% on a seven-day-a-week timetable.
TPE is gradually re-introducing some pre-cancelled services. On 3 February, yesterday, 22 of the 32 Liverpool to Edinburgh/Edinburgh to Liverpool journeys were reintroduced, and on 17 February the remaining 10 journeys will be reintroduced. On 30 March, the Northallerton and Darlington skip stops will also be reintroduced. However, because of the late delivery of and technical issues experienced by some of its new trains, and the unavailability of train crews as a result of shortened timescales for training, TPE customers are experiencing an unacceptable level of service cancellations and disruption. TPE is, therefore, compensating some customers for the disruption. Passengers who held a season ticket between 1 October and 31 December in 2019 will be eligible for a 3% rebate, which will more than cover the 2.8% average increase on regulated fares. In the short term, from yesterday TPE has improved its compensation arrangements so that passengers will get money back from the price of their ticket if trains are delayed by 15 minutes or more.

Kevan Jones: Will the Minister have a look at the way in which TPE pays its compensation, as this is complicated and people just give up when they do it. TPE might make those claims about compensation, but it is not actually doing it in practice.

Chris Heaton-Harris: I will happily look into how compensation is paid to TPE customers. I understand completely the right hon. Gentleman’s point about how poor the information to TPE customers has been. Something that we would think would be quite easy to get right, and that rail passengers across the piece appreciate, is honest information on why services cannot run. A bit more transparency could help to lessen some of the anger that is quite rightly felt by passengers when they are literally left in the dark.
Let me turn to the franchise itself. We have been clear with the operator that it must take urgent steps to address the poor performance. If necessary, my Department will take action under the terms set out in the franchise agreement. As I mentioned earlier, over the next two months TPE will reinstate the services that it took out as part of the temporary timetable that followed the issues with the delayed introduction of rolling stock in December. The Secretary of State and I recently met the managing director of the franchise, Network Rail and the manufacturers of the new trains, CAF and Hitachi. We did not use Anglo-Saxon language, as many customers might have been using recently, but we made it perfectly clear that they must take urgent steps to improve their services.
I did not know about the issues with ticket machines at the right hon. Gentleman’s local station. I will take that away, find out a bit more and come back to him, if that is okay. If a ticket machine is broken, we would always expect the train operating company to use the discretion available to it. We would not expect people to be charged penalty fares in such circumstances, so I will happily take that issue away.
I will check and come back to the right hon. Gentleman, but I would expect the improvements to the station by Northern to continue to go ahead as normal. I know that he is fairly sceptical about the opening of new lines, but I have been contacted by a local activist near to the right hon. Gentleman called Christopher Howarth who is keen to see the railway between Sunderland and  Durham reopened. As a viaduct fan, I can say that there is one of the most beautiful viaducts I have ever seen along that route, so I very much hope that those plans will come to fruition.
I thank the right hon. Gentleman for the way he has gone about this debate. He has been as positive as he can be and quite rightly demanding for his constituents. I hope and expect that in a year’s time he will not have  to come back and go through all this again because we will have sorted this: the new rolling stock will be working properly, the timetables will work properly and, indeed, all the drivers will be trained appropriately.
Question put and agreed to.
House adjourned.